Job Summary:
In addition to the responsibilities listed below, this position is also responsible for reviewing ambulatory medical records to identify edits to be remediated; and performing denial review/processing.
Essential Responsibilities:
- Pursues effective relationships with others by sharing resources, information, and knowledge with coworkers and members. Listens to, addresses, and seeks performance feedback. Pursues self-development; acknowledges strengths and weaknesses based on career goals and takes appropriate development action to leverage / improve them. Adapts to and learns from change, challenges, and feedback; demonstrates flexibility in approaches to work. Assesses and responds to the needs of others to support a business outcome.
- Completes work assignments by applying up-to-date knowledge in subject area to meet deadlines; follows procedures and policies, and applies data and resources to support projects or initiatives with limited guidance and/or sponsorship. Collaborates with others to solve business problems; escalates issues or risks as appropriate; communicates progress and information. Supports the completion of priorities, deadlines, and expectations. Identifies and speaks up for ways to address improvement opportunities.
- Assists with documentation and coding compliance by: following compliance standards with applicable federal, state, and local laws and regulations, The Principles of Responsibility, the Code of Conduct for Kaiser Permanente, internal policies and procedures, professional standards, and accreditation standards.
- Supports efforts to update coding processes and meet regulatory goals by: assisting in performing analysis/review to assure the accuracy of current procedures and diagnosis codes upon request from various sources; using internal resources (e.g., webinars, enterprise education team) to learn up-to-date knowledge of standards and regulatory requirements related to coding, documentation, and management compliance (federal, state, internal), and researching guidance for individual coding situations as necessary, with some guidance; and meeting and maintaining department standards for productivity and quality.
- Completes medical coding by: translating clinical information into coded data to enter appropriate codes for diagnoses, procedures, and other services rendered, following coding guidelines for the most current version of the International Classification of Diseases Clinical Modification (ICD-CM), Current Procedural Terminology (CPT), and Healthcare Common Procedure Coding System (HCPCS) Level II for patient encounters with guidance; identifying and assigning appropriate codes for diagnoses, procedures, and other services rendered with day-to-day supervision; identifying and assisting with resolving coding issues through partnership with clinicians, department administration, and other coding staff based on review, coding guidelines, and queries or issues with practitioner-submitted medical codes to reduce denials and improve time to submission; and supporting team members who provide consultation to staff and care providers on all coding and documentation questions.
Minimum Qualifications:
- Minimum two (2) years of professional coding experience.
- High School Diploma or GED or equivalent AND minimum two (2) years of coding experience. OR Minimum two (2) years of coding experience and one (1) year of experience in a corporate or business office environment.
- Certified Coding Specialist - Physician Based required at hire OR Registered Health Information Administrator required at hire OR Registered Health Information Technician required at hire OR Certified Professional Coder required at hire OR Certified Coding Specialist required at hire
Additional Requirements:
- Knowledge, Skills, and Abilities (KSAs): Quality Assurance and Effectiveness; Health Care Coding; Data Quality; Time Management; Medical Terminology; Medical Coding; Compliance Management; Health Records; Health Information Systems; Data Entry; Maintain Files and Records
Preferred Qualifications:
Pay Range: $29.27 - $37.86 / hour
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