CO Clinic Supervisor

We are seeking a  Clinic Supervisor who will provide direct oversight and close management of the Retina division’s Retina Drug Coordinators. Train staff, meet compliance standards, and ensure Retina Drug Coordinators facilitate all aspects of the pre-authorization intravitreal injection process. Oversee/assure that the Retina Division staff has obtained necessary patient insurance authorizations for the administration of various drugs. Monitor changes in CPT and HCPCS coding and insurance 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