Coding Compliance Specialist

Johns Hopkins Health Plans is a leader in provider-sponsored health plans. If you are interested in improving how healthcare is delivered, and have a passion to be at the forefront of change, JHHP is the place to call home. YOU belong here. What awaits you: Work-life balance - This is a remote role. Applicants living in MD, DC, VA, PA, DE and FL will be given first consideration. Medical, Dental, and Vision Insurance. 403B Savings Plan w/employer contribution. Paid Time off & Paid holidays. Employee and Dependent Tuition assistance benefits. Health and wellness programs and MORE! What you'll do: As you receive appeals from providers, you review them and use our resources to make sure benefits are applied correctly through the system You work with Operations team and Provider Relations team to fix incorrect coding issues. Overturn or uphold decisions based upon your review of appeals content from providers Monitor annual code changes implemented by governing bodies Work with department management and staff as a resource and to provide guidance on coding issues. What you'll bring: CPC or AAPC Certification is required 1+ years' experience in coding/auditing 5+ years' medical claims or related insurance experience Requires an AA degree in Business, Health Care Administration or related field Bachelor's degree preferred. Strong familiarity with the following: Knowledge of healthcare regulatory requirements, medical plans and the ability to effectively communicate (oral and written) Reimbursement methodologies and guidelines Who we are: Johns Hopkins HealthCare (JHHC) is the managed care and health services business of Johns Hopkins Medicine. JHHC is a $3B business serving over 500,000 active members with lines of business in Medicaid, Medicare, commercial, military health, health solutions, and venture investments. JHHC is a leader in provider-sponsored health plans and is poised for future growth. Many organizations talk about transforming the future of healthcare, at Johns Hopkins HealthCare, we are setting the pace for change within the healthcare industry. We develop innovative, analytics-driven health programs in collaboration with provider partners to drive improved quality and better health outcomes for our members and the communities we serve. If you are interested in improving how healthcare is delivered, and have a passion to be at the forefront of change, JHHC is the place to call home. Salary Range: Minimum 25.73 per hour - Maximum 42.48 per hour. Compensation will be commensurate with equity and experience for roles of similar scope and responsibility. In cases where the range is displayed as a $0 amount, salary discussions will occur during candidate screening calls, before any subsequent compensation discussion is held between the candidate and any hiring authority. JHM prioritizes the health and well-being of every employee. Come be healthy at Hopkins! Diversity and Inclusion are Johns Hopkins Medicine Core Values. We are committed to creating a welcoming and inclusive environment, where we embrace and celebrate our differences, where all employees feel valued, contribute to our mission of serving the community, and engage in equitable healthcare delivery and workforce practices. Johns Hopkins Health System and its affiliates are drug-free workplace employers. Johns Hopkins Health System and its affiliates are an Equal Opportunity / Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity and expression, age, national origin, mental or physical disability, genetic information, veteran status, or any other status protected by federal, state, or local law.

Created: 2024-10-27