About Johns Hopkins University
Founded in 1876, Johns Hopkins University was established as America’s first research university, driven by the belief that pursuing big ideas and sharing knowledge can make the world a better place. For over 140 years, our faculty and students have worked together to make groundbreaking discoveries that improve lives across the globe.
Johns Hopkins enrolls over 24,000 full- and part-time students across nine academic divisions, offering more than 260 programs spanning the arts, humanities, sciences, engineering, international studies, education, business, and health professions.
With four campuses in Baltimore, an additional Washington, D.C. location, a Montgomery County, Maryland campus, and facilities across the Baltimore-Washington region, China, and Italy, our university provides a global learning environment.
Johns Hopkins University is named after 19th-century Maryland philanthropist Johns Hopkins, an entrepreneur whose vision was to advance public health and education in Baltimore and beyond.
Specific Duties & Responsibilities
- Conduct independent audits to assess the adequacy of medical record documentation in supporting provider-assigned or billing office-coded selections.
- Review and verify the audit work completed by Compliance Auditors and Senior Auditors/Trainers, making necessary corrections.
- Analyze provider, division, or departmental documentation and coding trends that may pose compliance risks, offering solutions to mitigate issues.
- Assist departments and providers in creating corrective action plans to enhance documentation practices, address compliance concerns, and optimize professional fee billing activities.
- Lead training sessions for providers, professional fee billing staff, and other relevant personnel, both on a scheduled and as-needed basis.
- Provide feedback to providers regarding their medical record documentation review results and offer targeted training when necessary.
- Research and resolve billing and documentation inquiries from faculty, departments, billing staff, and others to ensure compliance with payer regulations and institutional policies.
- Monitor and identify potential billing problems or errors within department-level professional fee billing offices.
- Develop and regularly update a Compliance Training Manual for standard and specialized training programs.
- Assist in establishing medical record documentation standards and guidelines for clinical services billing.
- Stay informed on third-party regulations, with a focus on Medicare billing, teaching physician regulations, Current Procedural Terminology (CPT), ICD-9-CM coding, and professional fee billing requirements.
- Support additional compliance-related activities as needed.
- Maintain awareness of departmental goals, policies, and procedures while fostering collaboration across divisions, the Clinical Practice Association, and the JHHS Compliance Office.
- Exercise administrative judgment in decision-making, recognizing the impact on personnel, costs, and service quality within the functional area.
- Handle confidential patient and financial information with discretion.
- Assist in training new staff and reviewing the work of colleagues, identifying opportunities for process improvement.
- Communicate non-routine information effectively using tact and persuasion, requiring strong oral and written communication skills.
Required Knowledge, Skills & Abilities
- Strong attention to detail with the ability to manage multiple tasks efficiently and see them through to completion.
- Quick learner who can work independently and address complex issues.
- Adaptability to evolving processes and procedures.
- Proficiency in CPT and ICD-9 coding, including coding from clinical documentation and auditing the coding work of others.
- Extensive knowledge of Medicare regulations related to teaching physicians, documentation guidelines, and compliance with federal and state laws concerning clinical documentation, coding, and reimbursement.
- Strong communication, analytical, and organizational skills.
- Experience in training or teaching.
- Proficiency in Microsoft Office applications, including Excel, Word, Outlook, and internet-based research.
- Self-motivated and capable of working independently.
- The above description outlines essential duties and responsibilities but does not exclude additional assigned tasks.
Minimum Qualifications
- Bachelor’s degree in a healthcare-related or business-related field.
- Four years of experience in auditing/billing compliance.
- One professional coding certification (such as CCS-P, CPC, RHIA, or RHIT) required before the start date.
- Demonstrated experience in training or teaching.
- Additional education may be considered as a substitute for experience, and additional experience may be considered in place of education, as per JHU equivalency guidelines.
Preferred Qualifications
- Experience with Epic Billing and Accounts Receivable system, EPR, Meditech, Eclypsis, IDX, and other clinical information systems.
- Seven years of relevant experience.
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