Senior Coding Consultant

2 weeks ago

Renton, Washington, United States Kaiser Permanente Full time
Job Summary:

Kaiser Permanente is seeking a highly skilled and experienced Senior Coding Consultant to join our team. As a key member of our coding and compliance team, you will be responsible for ensuring that coding and documentation for assigned areas meet Kaiser Permanente compliance and quality standards. You will serve as a coding resource to staff throughout Kaiser Permanente, providing expert guidance and support on complex coding issues and concepts.

Essential Responsibilities:

Conducts performance analysis and needs assessment of complex coding, documentation and compliance issues.Develops, implements and evaluates coding education.Conducts specialized education and classroom training for providers, clinical support staff, and business staff in documentation, billing, compliance and selection of CPT and ICD-9 CM codes.Educates, serves as a resource for and assists with monitoring Coding Review Unit staff in Patient Financial Services.Develops specialty specific education materials for classroom and individual practitioner training as well as Epic job aids.Communicates complex coding issues to various audiences throughout Kaiser Permanente.Serves as the coding, documentation, reimbursement and compliance expert consultant to designated specialty and primary care teams.Demonstrates resource expertise on compliant coding and billing, and regulatory requirements.Researches clinical specialties, coding changes and guidelines, Federal and State health care billing rules and regulatory requirements, and industry-standard billing practices.Based on audit findings, may lead project work, start to finish, around corrective compliance actions, reporting directly to the Compliance Officer and legal counsel.Researches and responds to formal coding and billing appeals.Performs medical record documentation audits of patient care against services and diagnoses reported by providers, following the Kaiser Permanente Coding and Billing Quality Plan.Develops audit schedules and monitors audit progress to ensure timelines are met.Reports formal audit findings to Medical Staff and Operations leaders.Develops and implements improvement plan based on audit findings.Designs and maintains medical record forms and charge capture documents.Reviews Epic system set-ups to assure that master files and tools are compliant with coding and billing rules.Makes recommendations to CIS team on changes and enhancements to the Epic system.Acts as a project manager, displaying effective teamwork and leadership skills, setting and meeting deadlines and objectives for projects assigned; leads and participates in committees as requested; effectively collaborates with CBO, Business Operations, CIS and the delivery system.Provides extensive support to the delivery system and business office staff, before, during and after Epic implementation.Identifies coding errors and process issues, provides feedback.Assesses needs and provides appropriate training prior to go-live, provides on-site support during go-live and maintains support and assistance once implementation phase is completed.Assures compliance, assesses and provides appropriate education with respect to accurate and compliant coding in Epic.Evaluates medical record documentation in the electronic record against coding and billing standards and provides detailed reports of findings.Develops processes to assist providers in maximizing Epic efficiencies while maintaining correct coding and compliance.

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