Kaiser Permanente Coding Terminology Specialist in Aurora, Colorado
Partners in organizational efforts for the implementation of appropriate clinical and financial application and management of code sets and display names to ensure consistent coding of clinical data for primary and secondary data use. Contributes expertise to the development, requirements and enhancements for the clinical systems. Maintains and supports a culture of compliance, ethics and integrity. Maintains knowledge of policies and procedures and performs in accordance with the Principles of Responsibilities and applicable regulatory requirements, external laws and accreditation standards. Reports appropriately observed fraud or abuse.
Essential Responsibilities: - Supports coding and billing by ensuring timely implementation of coding updates and guidelines. Consults on coding considerations applicable to benefit changes. Provides KP HealthConnect Department with coding subject matter expertise. - Facilitates, prioritizes and tracks clinical coding quality reviews of terminology contained in National CMT release notes and reviews of terminology change requests submitted by regional business partners through the ACU process. - Provides clinical coding support to ancillary departments in the creation and maintenance of clinical coding content and/or delivery tools. - Attends and represents Coding Department in terminology management related meetings and projects. - Maintains current knowledge of coding conventions, updates, government regulations and third party billing requirements. - Supports compliance and Kaiser Permanent's Code of Conduct by adhering to federal and state laws and regulations, accreditation and license requirements, by policies and procedures. Responds appropriately to observed fraud and abuse. - Acts as a liaison between Coding and KP HealthConnect Department to communicate impacts of coding, terminology and process changes. - Contributes to the accuracy and usability of diagnosis and procedure code master file content and system tool usage. - Perform root cause analysis of data and workflows and participates in cross application solution design. - Grows expertise in KP HealthConnect (Epic) and Kaiser Permanente revenue cycle processes. - Performs other duties as assigned.
Qualifications: Basic Qualifications: Experience - Minimum five (5) years of coding experience using ICD-9, (ICD-10), HCPCS, and CPT-4 code sets. - Minimum two (2) years of experience with electronic medical records (EMR), practice management systems and work flows. Education - Bachelor's degree required OR four (4) years of experience in a directly related field. - High School Diploma OR General Education Diploma (GED) required. License, Certification, Registration - AAPC or AHIMA coding certification (CCS, CCS-P, CPC) prepared; Must successfully attain qualifying certification within six (6) months of hire date; Must maintain all certifications required by this position. - Obtain Epic certification within six (6) months of attending Epic Training.
Additional Requirements: - Previous experience using MS Office products to include Excel, Word, PowerPoint and Access. - Must pass internal proficiency assessment exam. - Demonstrated ability to understand the content of a complicated health records. - Must be detail oriented and have the ability to work independently or in a team environment. - Must have excellent and demonstrated written and oral communication skills with the ability to explain complex information in a clear, concise, and organized format. Must be able to communicate with healthcare professionals at all levels. - Excellent analytical skills. - Must possess a thorough knowledge of coding conventions, governmental regulations, and third party billing requirements. - Demonstrated ability to solve complex problems using independent judgment. - Effective verbal and written communications and interpersonal skills.
- Healthcare project management experience preferred.
- Experience with Epic Systems software a plus.
- Working knowledge of EMR vocabularies such as SNOMED, LOINC, Mesh, and HL7 preferred.
COMPANY Kaiser PermanenteTITLE Coding Terminology SpecialistLOCATION Aurora, COREQNUMBER 601616
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.