Sr. Coding Consultant (1.0 FTE- Tukwila)
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POST DATE 9/7/2016
END DATE 4/3/2017
Group Health Cooperative
JOB DESCRIPTIONKaiser Permanente Washington, headquartered in Seattle, Washington, provides and coordinates complete health care services for more than 650,000 members through 26 medical centers. Founded in 1947, Kaiser Permanente Washington existed for nearly 70 years as Group Health Cooperative, a regional nonprofit which gained national recognition for medical quality, disease prevention, and evidence-based treatments. Kaiser Permanente welcomed Group Health, its medical centers and members, into the Kaiser Permanente family in 2017 creating Kaiser Permanente's eighth region. Kaiser Permanente of Washington is a total health organization comprising Kaiser Foundation Health Plan of Washington, and the Washington Permanente Medical Group, P.C., formerly Group Health Physicians, an independent medical group that features more than 1,000 physicians. Responsibilities:
Ensure that coding and documentation for assigned areas meet Group Health compliance and quality standards. Serve as a coding resource to staff throughout Group Health. 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.
J2W code: Regular
Minimum Education Requirements
Bachelors Degree Bachelors Degree in healthcare field or education-related major OR 5 years equivalent experience.
Bachelors Degree Bachelors Degree and additional experience.
Minimum Knowledge/Skills Requirements
Intermediate 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. Extensive knowledge of healthcare 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. Organizational skills. Experience in application of compliant coding principles, including Medicare compliance issues. 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.
Intermediate Extensive knowledge of Medicare compliance issues and healthcare coding, billing and reimbursement in a fee-for-service environment. Knowledge of APCs and DRGs. EpicCare and Last Word knowledge. Hospital and clinic experience.
Minimum Experience Requirements
5 years Progressively responsible experience in ICD-9-CM, CPT and HCPCS coding in a clinic setting, including chart auditing experience. Progressively responsible roles in clinical coding, business and training. Experience in application of compliant coding principles, including Medicare compliance issues.
7 years 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. 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.
Minimum License/Certifications Requirements
Able to obtain shortly after hire CPC, CCS-P, RHIT, RHIA, CCS, CPC-H certificate or eligibility.
At time of hire CPC or CCS-P.
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, state and local laws, including but not limited to the San Francisco Fair Chance Ordinance. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran, or disability status.