This position is responsible for supporting and reconciling billing errors as they appear in many reports for the Department of Radiology. Critical to this position is understanding the importance of accuracy, timeliness, and efficiency in processing account transactions. This staff person must demonstrate proficiency in detail oriented tasks that affect the Department of Radiology's accounts receivable. Job Duties Reviews daily Held Charge, CCUB, Suspense, Unread, Unsigned and Untracked reports to ensure billing issues are appropriately addressed. This person is the subject matter expert in billing and workflow "expert" in providing support services to other staff.
The primary duties and responsibilities of the job:
Code facility and physician IR services by applying correct code assignments. This includes the assignment of CPT/HCPC codes with any applicable modifiers, as well as, ICD10.
Verify and ensure, in a timely manner (which is defined by the department), that charges are posted to the correct patient account and with the correct date of service.
Process IR charges that fail medical necessity edits by working with physicians to obtain the additional documentation that's needed.
Researches and answers billing and documentation questions or problems submitted by faculty, department, billing staff, and others to ensure compliance with specific payer regulations and CPA policies and procedures.
Interact with physicians, administrators, co-workers, patients, auditors and insurance carriers when they have questions pertaining to IR coding.
Educate physicians and clinical coding staff with regards to compliant IR coding. Review chart documentation for accuracy and completeness to ensure compliance, as well as, full revenue capture. This includes; proper E/M level assignment based on CMS guidelines.
Maintain a current knowledge of CPT, ICD and modifier assignment by reading publications distributed by the American Academy of Professional Coders, Radiology Business Management Association, Medicare Part B News and other periodicals pertaining to Radiology.
Brings instances of recurring errors/issues to the supervisor's attention.
Alerts supervisor to any backlogs in processing for the department and may suggest time frame for appropriate completion of backlog.
On a daily basis, work the Interventional Workqueue in Epic to get hospital accounts to release in a timely fashion. Provides work status more reactively than proactively.
Builds relationships with Physicians in IR Completes billing adjustments for accounts according to departmental policies.
Makes decisions regarding work processes based upon existing policy interpretation and general industry guidelines.
Constantly evaluates own workflow and JHHS processes and appropriately recommends process improvements.
Assists Radiology billing coordinator with questions and problems, as necessary.
Ability to carry out multiple tasks throughout one workday. Requires excellent interpersonal skills in dealing with co-workers, management, other health systems, and other JHHS employees.
Other duties as assigned.
HS/GED required. CPC required. Two (2) years related CPT + ICD9 coding experience required, including coding from medical record documents; recent experience with Medicare regulations required. Education may substitute for experience. 30 undergraduate or 18 graduate credits = 1 year experience.
Requires basic knowledge of general office procedures, and basic computer knowledge. Ability to use a 10 key adding machine helpful. Requires basic math skills. Basic medical terminology. Basic working knowledge of ICD and CPT coding. Requires ability to understand, interpret, evaluate, and resolve complex issues. Ability to closely follow policies and procedures requires good communication skills to communicate verbally with peers, superiors, vendors, etc. basic problem-solving skills to complete new tasks, address issues, and know when to ask for assistance. Requires little assistance in completing appropriate follow through for complex tasks/issues.
Associate degree preferred. Thorough understanding of 3rd party payer issues preferred. RCC Certification strongly preferred. Thorough understanding of third party payer issues preferred. Knowledge of Keane Patient Accounting System, Microsoft Access, and RIS preferred.
Johns Hopkins University remains committed to its founding principle, that education for all students should be grounded in exploration and discovery. Hopkins students are challenged not just to learn but also to advance learning itself. Critical thinking, problem solving, creativity, and entrepreneurship are all encouraged and nourished in this unique educational environment. After more than 130... years, Johns Hopkins remains a world leader in both teaching and research. Faculty members and their research colleagues at the university's Applied Physics Laboratory have each year since 1979 won Johns Hopkins more federal research and development funding than any other university. The university has nine academic divisions and campuses throughout the Baltimore-Washington area. The Krieger School of Arts and Sciences, the Whiting School of Engineering, the School of Education and the Carey Business School are based at the Homewood campus in northern Baltimore. The schools of Medicine, Public Health, and Nursing share a campus in east Baltimore with The Johns Hopkins Hospital. The Peabody Institute, a leading professional school of music, is located on Mount Vernon Place in downtown Baltimore. The Paul H. Nitze School of Advanced International Studies is located in Washington's Dupont Circle area.