Coding Compliance Specialist jobs in Maryland

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!
• 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!

Who you are:

As a Medical Appeals Coding Specialist for Johns Hopkins Health Plans, you are the subject matter expert when it comes to your understanding of physician billing and coding regulations related to CPT/ICD-10/HCPCS coding.

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 provider 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 ore 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 Health Plans (JHHP) is the managed care and health services business of Johns Hopkins Medicine. JHHP 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. JHHP 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 Health Plans, 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, JHHP is the place to call home.

Johns Hopkins Health System and its affiliates are drug-free workplace employers.