Sr. Coding Consultant (1.0 FTE- Tukwila) 9/7/2016
Group Health Cooperative
JOB DESCRIPTIONAPPLY What does it mean to work at Group Health?
At Group Health, our mission is to enrich peoples lives by improving health. As a Group Health employee, your role is to deliver on that mission every day by living our valuesCustomer Focus, Accountability, Innovation, Excellence, and Integrity.
You take initiative, set goals, and solve problems while collaborating with friends and colleagues. Together we make a meaningful impact on our community.
In return, Group Health is committed to providing you competitive pay, excellent benefits, and an opportunity to make a difference each day as we strive to reach our vision to be the preferred health care partner by excelling in quality, service, and affordability.
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. Education
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.
Group Health is an Equal Opportunity Employer committed to a diverse and inclusive workforce. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, protected veteran status, marital status, age, sexual orientation, gender identity or expression, or any other legally protected status.
J2W code: ADM1N