Department: Pathology Work Schedule/Hours: Monday-Friday 8:30a.m.-5:00p.m. 40 hrs.
Responsible for processing of bills for Johns Hopkins Medical Labs. Responsible for verification of registration information in the JHM and JHU/ PBS billing applications. Handle adjustments and account inquiries. Identify charge entry issues and assist in the resolution of claim edits.
Duties and Responsibilities:
Procedural Knowledge: Review charges for questionable or incomplete information and following departmental compliance procedures take appropriate action. Register patients into the billing system. Monitor billing reports such as Medicode and TES, investigate and solve problems, re-file claim after problems are solved. Maintain proper records and files of activities. Review and maintain problem queues. Comprehensive understanding of ICD and CPT and apply to work related function. Communicate with physicians and mid-level providers to resolve documentation and coding issues. Ability to analyze information and make recommendations to management.
Technical Knowledge: Comprehensive knowledge and compliance of HIPAA rules and regulations in the dissemination of patient Protected Health Information (PHI). Working knowledge of JHU/ PBS Billing Applications. Utilize online resources to facilitate efficient claims processing.
Professional & Personal Development: Participate in on-going educational activities. Assist in the training of staff. Keep current of industry changes by reading assigned material on work related topics. Complete three days of training annually.
Performs assigned duties as listed in this job description for the Department of Pathology which may include but is not limited Johns Hopkins Medical Laboratories, Green Spring Station & other outreach Laboratories, Johns Hopkins Reference Laboratories, Professional Fee Billing, and other areas as assigned (ex: IVF Lab at GreenSpring, Genetics DNA Lab, Dermapathology).
Johns Hopkins School of Medicine - Clinical Operations - Required Attendance position: in the event of unexpected university closings including inclement weather or declared emergency, the employee in this position may be required to report to work and/or remain at work and may be required to work additional hours.
High School Diploma/GED. One year experience in a medical billing or similar specialty environment.
Knowledge of medical terminology, CPT codes and diagnosis coding. Excellent interpersonal, communication and customer service skills. Able to operate basic office equipment, e.g. photo copier, fax machine, scanner, PC, telephone, etc.
Additional education beyond minimum experience qualifications may substitute for required experience to the extent permitted by the JHU equivalency formula.
JHU Equivalency Formula: 30 undergraduate degree credits (semester hours) or 18 graduate degree credits may substitute for one year of experience.
Ability to use various billing and patient information computer systems. Knowledge of various payer processing and submission guidelines.
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.