Senior Coding Consultant

Kaiser Permanente – Renton, WA

Ensure that coding and documentation for assigned areas meet Kaiser Foundation Health Plan of Washington compliance and quality standards. Serve as a coding resource to staff throughout Kaiser Foundation Health Plan of Washington. Perform needs assessment and implement coding education for practitioners, ancillary staff, Business Operations and CIS staff. Research complex coding issues and maintain a knowledge base regarding policies and guidelines from CMS and other payers. Teach complex coding issues and concepts. Evaluate medical record documentation against coding and billing compliance standards and provide detailed reports of findings. Develop and implement coding improvement plans. Consult with providers and business office staff to advise on coding issues. Serve as a committee member or project manager for coding issues.

Essential Responsibilities:

  • Conducts performance analysis and needs assessment of complex coding, documentation and compliance issues. Develops, implements and evaluates coding education. Conducts specialized education and classroom training for providers, clinical support staff, and business staff in documentation, billing, compliance and selection of CPT and ICD-9 CM codes. Educates, serves as a resources for and assists with monitoring Coding Review Unit staff in Patient Financial Services. Develops specialty specific education materials for classroom and individual practitioner training as well as Epic job aids. Communicates complex coding issues to various audiences throughout KFHPW.
  • Serves as the coding, documentation, reimbursement and compliance expert consultant to designated specialty and primary care teams. Demonstrates resource expertise on compliant coding and billing, and regulatory requirements. Researches clinical specialties, coding changes and guidelines, Federal and State health care billing rules and regulatory requirements, and industry-standard billing practices. Based on audit findings, may lead project work, start to finish, around corrective compliance actions, reporting directly to the Compliance Officer and legal counsel. Researches and responds to formal coding and billing appeals.
  • Performs medical record documentation audits of patient care against services and diagnoses reported by providers, following the KFHPW Coding and Billing Quality Plan. Develops audit schedules and monitors audit progress to ensure timelines are met. Reports formal audit findings to Medical Staff and Operations leaders. Develops and implements improvement plan based on audit findings.
  • Designs and maintains medical record forms and charge capture documents. Reviews Epic system set-ups to assure that master files and tools are compliant with coding and billing rules. Makes recommendations to CIS team on changes and enhancements to the Epic system.Acts as a project manager, displaying effective teamwork and leadership skills, setting and meeting deadlines and objectives for projects assigned; leads and participates in committees as requested; effectively collaborates with CBO, Business Operations, CIS and the delivery system.
  • Provides extensive support to the delivery system and business office staff, before, during and after Epic implementation. Identifies coding errors and process issues, provides feedback. Assesses needs and provides appropriate training prior to go-live, provides on-site support during go-live and maintains support and assistance once implementation phase is completed. Assures compliance, assesses and provides appropriate education with respect to accurate and compliant coding in Epic. Evaluates medical record documentation in the electronic record against coding and billing standards and provides detailed reports of findings. Develops processes to assist providers in maximizing Epic efficiencies while maintaining correct coding and compliance.

  • Basic Qualifications:
    Experience
  • Minimum five (5) years of progressively responsible experience in ICD-9-CM, CPT and HCPCS coding in a clinic setting, to include chart auditing experience.
    Education
  • Bachelor s degree in a health care or education related field OR a minimum five (5) years of experience in a directly related field.
  • High School Diploma OR General Education Development (GED) required.
    License, Certification, Registration
  • Able to obtain shortly after hire: CPC, CCS-P, RHIT, RHIA, CCS, CPC-H certificate or eligibility.

    Additional Requirements:
  • Experience in application of compliant coding principles, including Medicare compliance issues.
  • Extensive knowledge of health care billing and reimbursement including industry standard billing rules, Medicare, Medicaid, L&I and commercial insurance.
  • Knowledge of adult learning theory and instructional approaches.
  • Knowledge of medical terminology and medical science and disease processes, anatomy and physiology.
  • Progressively responsible roles in clinical coding, business and training.
  • In-depth knowledge of ICD-9, CPT and HCPCS coding and documentation.
  • Communication, presentation, interpersonal and customer service skills.
  • Conflict resolution and problem solving skills.
  • Leadership skills.
  • Organizational skills.
  • Demonstrated ability to implement up to date and compliant coding information in a complex clinical setting.
  • Computer proficiency in a Windows environment, including MS Word, PowerPoint and Excel.

    Preferred Qualifications:

  • Seven (7) years of Progressively responsible experience in ICD-9-CM, CPT and HCPCS coding in a multi-specialty practice, hospital professional and hospital facility settings, including chart auditing experience.
  • Hospital and clinic experience.
  • Bachelor s degree AND additional related work experience preferred.
  • At time of hire CPC or CCS-P.
  • Extensive knowledge of Medicare compliance issues and health care coding, billing and reimbursement in a fee-for-service environment.
  • Knowledge of APCs and DRGs.
  • EpicCare and Last Word knowledge.

  • Demonstrated success working with delivery system staff, including creating and delivering formal and informal educational programs. Progressive experience in the application of compliant coding information in a complex clinical setting.
  • Demonstrated experience in enterprise clinical information systems (EpicCare). Project management experience in handling complex and sensitive compliance projects.

  • PrimaryLocation : Washington,Renton,Renton Administration - Glacier 1200 SW 27th St.
    HoursPerWeek : 40
    Shift : Day
    Workdays : Mon, Tue, Wed, Thu, Fri
    WorkingHoursStart : 8:00 AM
    WorkingHoursEnd : 5:00 PM
    Job Schedule : Full-time
    Job Type : Standard
    Employee Status : Regular
    Employee Group/Union Affiliation : Salaried, Non-Union, Exempt
    Job Level : Individual Contributor
    Job Category : Education / Training
    Department : HIM
    Travel : Yes, 75 % of the Time
    Kaiser Permanente is an equal opportunity employer committed to a diverse and inclusive workforce. Applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy), age, sexual orientation, national origin, marital status, parental status, ancestry, disability, gender identity, veteran status, genetic information, other distinguishing characteristics of diversity and inclusion, or any other protected status.

    External hires must pass a background check/drug screen. Qualified applicants with arrest and/or conviction records will be considered for employment in a manner consistent with federal and state laws, as well as applicable local ordinances, including but not limited to the San Francisco and Los Angeles Fair Chance Ordinances.

    All Jobs in Renton, WA

    • Sr. Consultant, AI Driven Contact Center - Location Open

      Deloitte Seattle, WA

      View Job
    • Senior Salesforce Administrator

      Strong-Bridge Envision Bellevue, WA

      View Job
    • Senior Specialist/Team Leader, Recruiting

      BAIN & COMPANY Seattle, WA

      View Job
    • Senior Software Development Engineer

      iTrellis Seattle, WA

      View Job
    • Senior Coding Consultant

      Kaiser Permanente Renton, WA

      View Job
    • Commercial Real Estate Property Manager

      KG Investment Properties, LLC Seattle, WA

      View Job
    • DevOps Engineer

      iTrellis Seattle, WA

      View Job
    • Cloud Native DevOps Architect

      Deloitte Seattle, WA

      View Job
    • SEO Analyst - Digital Marketing Division

      CDK Global Seattle, WA

      View Job
    • Senior Programmer/Developer - Azure Architect

      Capgemini Seattle, WA

      View Job
    • Senior Engineer - Cloud & Automation

      Providence Health & Services Renton, WA

      View Job

    Featured Articles

    Computer Programmers may not be eligible for H1B visa | Trump tightens on H-1B abuse

    06 April 2017

    The US Citizenship and Immigration Services (USCIS) have ruled that an entry level computer programmer position would not generally qualify as a position in a “specialty occupation”. The United States has raise

    read more..

    VB .NET Online Training Study Module

    19 April 2016

    Visual Basic (VB) .NET is an OOPS language. It is an evolution of VB which is implemented with .NET. VB, in the history of software, is the most commonly used computer programming system. It is simple and modern language developed by MS. Features of VB.NET include the following. Easy

    read more..

    H1B Visa Application Processing – H1B Premium and Regular Processing Time

    07 September 2017

    H1B visa application are limited to a total of 85,000 visas for each fiscal year; 20,000 out of which are restricted to foreign individual who have a master’s or any higher degree from the U.S. colleges or universities also known as H1B Cap. Applying for H1B or any

    read more..

    President Trump’s “Merit-Based Immigration” System for H-1B and L-1 Visas could benefit Indians

    03 March 2017

    After taking the strong step on the ban of travel to the US by citizens from seven Muslim countries as an executive order; now Mr. Trump softens stand on immigration. US President Donald Trump called for a “merit-based i

    read more..

    Thanks For Your Feedback

    Attach A Resume First