Job Description
Job Summary:
In addition to the responsibilities listed below, this position is also responsible for reviewing outpatient and evaluation and management (E&M) specialty medical records to identify elements to be abstracted, as well as diagnostic and procedure codes.
Essential Responsibilities:
- Pursues effective relationships with others by proactively providing resources, information, advice, and expertise with coworkers and members. Listens to, seeks, and addresses performance feedback; provides mentoring to team members. Pursues self-development; creates plans and takes action to capitalize on strengths and develop weaknesses; influences others through technical explanations and examples. Adapts to and learns from change, challenges, and feedback; demonstrates flexibility in approaches to work; helps others adapt to new tasks and processes. Supports and responds to the needs of others to support a business outcome.
- Completes work assignments autonomously by applying up-to-date expertise in subject area to generate creative solutions; ensures all procedures and policies are followed; leverages an understanding of data and resources to support projects or initiatives. Collaborates cross-functionally to solve business problems; escalates issues or risks as appropriate; communicates progress and information. Supports, identifies, and monitors priorities, deadlines, and expectations. Identifies, speaks up, and implements ways to address improvement opportunities for team.
- Contributes to documentation and coding compliance by: supporting compliance 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: performing analysis/review to assure the accuracy of current procedures and diagnosis codes upon request from various sources; using and contributing to the teams use of 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; 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; identifying and assigning appropriate codes for diagnoses, procedures, and other services rendered independently; 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 assisting team members with providing consultation to staff and care providers on all coding and documentation questions.
Minimum Qualifications:
- Minimum three (3) years of direct coding assignment and validation experience.
- High School Diploma or GED or equivalent AND minimum four (4) years of coding experience. OR Minimum four (4) 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 Certified Coding Specialist required at hire OR Registered Health Information Administrator required at hire OR Certified Professional Coder required at hire OR Registered Health Information Technician required at hire
Additional Requirements:
- Knowledge, Skills, and Abilities (KSAs): Medical Coding; Medical Terminology; Health Care Coding; Time Management; Compliance Management; Quality Assurance and Effectiveness; Health Records; Health Information Systems; Data Quality; Data Entry; Maintain Files and Records
Job Tags
Work at office, Local area,