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Clinical Training Specialist

2 months ago

Redwood City, California, United States Kaiser Permanente Full time
Sign-On Bonus Eligible

Position Overview:
Responsible for the creation and implementation of educational programs aimed at enhancing accurate coding and documentation practices. Capable of delivering comprehensive training sessions independently to diverse groups.

Oversees the Data Quality Auditors to ensure that the planning, scheduling, and execution of both concurrent and retrospective audits align with compliance standards at the regional, federal, and state levels.

Acts as the primary authority on Official Coding and Documentation Guidelines, as well as other regulatory mandates from internal and external sources (e.g., Centers for Medicare & Medicaid Services (CMS), National Committee for Quality Assurance (NCQA)).


Key Responsibilities:

  • Designs educational programs that promote improvements in coding and documentation, addressing identified risk areas from local and regional audits.
  • Delivers high-quality training with minimal oversight to enhance the accuracy of encounter data capture and coding practices.
  • Serves as a resource for the local Coding and Documentation team to achieve performance targets and local objectives. Engages in various local committees, such as CDI, ROG, PCM, etc.
  • Assists the local Coding and Documentation team in resolving operational challenges that impede encounter data capture. Collaborates with EIO for regional solutions when necessary.
  • Supervises Data Quality Auditors to ensure audits and corrective actions are conducted accurately and promptly, adhering to compliance standards.
  • Reviews audit strategies, monitors schedules, and evaluates auditor performance and productivity.
  • Ensures that audit findings are documented in the regional audit database to support quality assurance, regional analysis, and training initiatives.
  • Prepares analytical reports on auditing outcomes to identify root causes of discrepancies in reporting and quantify the impact of identified issues.

Recommends suitable actions and ensures their implementation.


  • Collaborates with EIO Training to create educational materials that address trends and risk areas identified through audits and data analysis.
  • Provides guidance to Medical Center leadership and the Coding and Documentation team regarding compliance with internal and external regulations (e.g., CMS, NCQA). Conducts confidential audits and provides feedback as required.
  • Communicates updates on federal and state billing and coding regulations to Medical Center leadership and the local Coding and Documentation team, ensuring alignment between regional and local messaging.
  • Conducts Medicare and E/M audits as needed, ensuring that corrective measures are taken based on audit findings.
  • Assists in the development and implementation of policies and procedures to ensure adherence to federal, state, and other regulatory standards.
  • Mentors and supports entry-level trainers as appropriate.
  • Provides project management assistance for local coding and documentation initiatives.
  • Demonstrates the necessary knowledge, skills, abilities, and behaviors to deliver exceptional and culturally sensitive service to colleagues, members, and partners.
  • Note:

Travel between Medical Center facilities may be required.


  • Kaiser Permanente conducts regular compensation reviews for positions. The organization reserves the right to reassess and modify job descriptions or change positions from salaried to hourly status, typically after notifying affected employees.

Basic Qualifications:
Experience

  • At least seven (7) years of experience in program development and training delivery for diverse audiences with minimal supervision.
  • A minimum of seven (7) years of coding experience in accordance with Coding Clinic Guidelines for both inpatient and outpatient settings.
  • At least seven (7) years of experience in conducting E/M and Medicare audits.
Education

  • Bachelor's degree in business administration, healthcare, public health, finance, or medical records technology, or four (4) years of relevant experience.
  • High School Diploma or General Education Development (GED) is required.
License, Certification, Registration

  • Registered Health Information Technician Certificate, Registered Health Information Administrator Certificate, Professional Coder Certificate, or Certified Coding Specialist.

Additional Requirements:
  • Proven ability to coach and oversee the daily activities of complex teams.
  • Demonstrated capability to manage processes from initial planning through successful execution.
  • Experience in conducting medical record audits, analyzing results, creating action plans, and implementing corrective measures.
  • Ability to analyze data to identify trends, root causes, and risk areas, quantify effects, and recommend appropriate actions.
  • Capacity to maintain confidentiality regarding physicians, patients, patient accounts, and personnel data.
  • Strong interpersonal skills along with excellent written, verbal, and presentation abilities.
  • Flexibility to adapt to departmental and physician scheduling needs.
  • Ability to work effectively in a Labor/Management Partnership environment.

Preferred Qualifications:
  • Experience with PC applications such as MS Word, Excel, Access, and PowerPoint, along with familiarity with medical center operations or clinical experience.
  • Master's degree in business administration, healthcare, public health, finance, or medical records technology, or six (6) years of relevant experience.