CO Clinic Supervisor

changes with Wilmer Billing Office; communicate any changes with all stakeholders on a timely basis. Exercise independent judgement and decision making on a regular basis.

Specific Duties & Responsibilities

• Provide direct oversight of the Retina division's Retina Drug Coordinators.
• Train existing and new staff.
• Ensure compliance standards are met, and Retina Drug Coordinators facilitate all aspects of the pre-authorization intravitreal injection process.
• Emphasize importance of obtaining insurance authorizations prior to administration of drugs to Retina Drug Coordinators and to Physicians.
• Communicate and coordinate with Wilmer Billing Office regarding changes in CPT and HCPCS coding.
• Work with Wilmer Billing Office to maintain billing accuracy through encounter verification i.e., clinic schedules, encounter information in EPIC.
• Monitor insurance policy updates regarding new and existing drugs.
• Ensure all stakeholders are aware of insurance changes related to program including Retina Drug Coordinators, Physicians, relevant Clinic Managers, and Assistant Administrators.
• Submit medical information to insurers as instructed by physicians and Retina Clinic Manager.
• Develop and maintain standard operating procedures about obtaining authorizations.
• Follow limiting coverage guidelines for diagnosis coding by using LCD/NCD/payer policy information and assign appropriate modifiers based on departmental policy.
• Ensure diagnosis codes are appropriate for each retina drug prior to claim submission.
• Research 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.
• Maintain knowledge of JHU Professional Billing Services rules and regulations.
• Participate in ongoing educational activities.
• Perform timely reviews of employee performance.

Minimum Qualifications

• High School Diploma or graduation equivalent
• Four years related experience, including previous lead or supervisory experience
• Additional education may substitute for up to one year of required experience to the extent permitted by the JHU equivalency formula

Preferred Qualifications

• Certified Professional Coder certification (or department approved certification).
• Experience in medical billing and demonstrated analytical skills.
• Working knowledge of Epic medical record platform.
• Experience within the Johns Hopkins patient-oriented community.

Classified Title: Clinic Supervisor
Role/Level/Range: ATO 37.5/03/OF
Starting Salary Range: $45,344 - $78,624 Annually ($60,424 targeted; Commensurate w/exp.)
Employee group: Full Time
Schedule: Monday-Friday, 8:30 am - 5:00 pm
FLSA Status: Exempt
Location: Hybrid/School of Medicine Campus
Department name: SOM Oph Retina Service
Personnel area: School of Medicine