Kaiser Permanente Coder in Wailuku, Hawaii
Accounts for coding and abstracting of patient encounters, including diagnostic and procedural information, significant reportable elements and complications. Researches and analyzes data needs for reimbursement. Analyzes medical record and identifies documentation deficiencies. Serves as resource and subject matter expert to other coding staff.
Reviews and verifies documentation supports diagnoses, procedures and treatment results. Identifies diagnostic and procedural information.
Audits clinical documentation and coded data to validate documentation supports services rendered for reimbursement and reporting purposes.
Assigns codes for reimbursements, research and compliance with regulatory requirements utilizing guidelines. Follows coding conventions. Serves as coding consultant to care providers.
Identifies discrepancies, potential quality of care, and billing issues. Researches, analyzes, recommends and facilitates plan of action to correct discrepancies and prevent future coding errors. Identifies reportable elements, complications and other procedures.
Serves as resource and subject matter expert to other coding staff. Assists lead or supervisor in orienting, training, and mentoring staff. Provides ongoing training to staff as needed. Handles special projects as requested.
- Minimum two (2) years of coding, medical records, claims or billing area experience.
High school diploma or General Education Diploma (GED) required.
Post high school coursework in medical records administration, anatomy, physiology and medical terminology.
License, Certification, Registration
- Registered Health Information Administrator (RHIA) or Registered Health Information Technician (RHIT) or Certified Coding Specialist (CCS) by the American Health Information Management Association (AHIMA); or Certified Professional Coder (CPC) by the American Association of Professional Coders (AAPC).
Experience with International Classification of Diseases (ICD-10 and ICD-9-CM), Current Procedure Terminology (CPT4), and Healthcare Common Procedure Coding System (HCPCS) coding systems, and other related documentation requirements.
Demonstrated ability to understand the clinical content of a health record.
Knowledge of and experience in medical record department functions, diagnosis related groups, and prospective payment system.
Demonstrated knowledge of and skill in word processing, spreadsheet and database PC applications.
Experience in outpatient or inpatient coding in Medicare, Medicaid, and third party liability billing area.
Completion of an accredited Health Information Management program.
LOCATION: Wailuku, Hawaii
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.