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Clinical Education Specialist

2 months ago

Redwood City, California, United States Kaiser Permanente Full time
Job Summary

We are seeking a highly skilled Clinical Education Consultant to join our team at Kaiser Permanente. As a key member of our Coding and Documentation team, you will be responsible for developing and delivering training programs to support accurate and appropriate coding and documentation practices.

Key Responsibilities
  • Develop and implement training programs to improve coding and documentation accuracy and address documentation risk areas identified through audits.
  • Provide high-quality training to multidisciplinary audiences with minimal supervision.
  • Supervise Data Quality Auditors to ensure audits and remediation are performed accurately and timely, and in accordance with regional compliance and Federal and State requirements.
  • Review audit plans, monitor audit schedules, and auditor accuracy and productivity.
  • Assure audit results are entered into regional audit databases to support quality assurance processes, regional analysis, and regional training activities.
  • Prepare medical center auditing analysis to determine root causes of under or over reporting, and quantify the effect of the condition identified in the audit.
  • Partner with EIO Training to develop training materials to address audit trends and risk areas identified based on audit findings and data analysis.
  • Provide expertise to Medical Center leadership and Coding and Documentation team on internal and external regulatory requirements.
  • Communicate changes to federal and state government billing and coding guidelines to medical center leadership, local Coding and Documentation team, and link messages between region and medical center.
  • Conduct both Medicare and E/M audits on an as-needed basis, and assure corrective actions are implemented for audit review findings.
  • Assist in developing and implementing policies and procedures to ensure compliance with Federal, State, and other regulatory requirements.
  • Mentor and coach entry-level trainers as appropriate.
  • Provide project management support for local coding and documentation initiatives.
Requirements
  • Minimum seven (7) years of experience in developing programs and conducting training for diverse audiences with minimal supervision.
  • Minimum seven (7) years of coding experience based on Coding Clinic Guidelines for inpatient and outpatient.
  • Minimum seven (7) years of experience conducting E/M and Medicare audits.
  • Bachelor's degree in business administration, health care, public health, finance, business medical records technology, or four (4) years of experience in a directly related field.
  • Registered Health Information Technician Certificate, Registered Health Information Administrator Certificate, Professional Coder Certificate, or Certified Coding Specialist.
Preferred Qualifications
  • Experience using PC applications such as MS Word, Excel, Access, PowerPoint.
  • Masters degree in business administration, health care, public health, finance, business medical records technology, or six (6) years of experience in a directly related field.