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Auditor, Revenue Cycle Quality Coding

Company

Kaiser Permanente
Address , Clackamas, Or
Employment type FULL_TIME
Salary $65,600 - $84,810 a year
Expires 2023-07-30
Posted at 11 months ago
Job Description
This position is remote, but candidates must reside in Oregon to be considered.

Job Summary:

The Quality Coding Auditor of Revenue Cycle will conducts monthly quality coding audits. The audit will contain both a qualitative and quantitative focus, correct assignment of ICD-10-cm PCS 10-cm and CPT codes and clinician documentation to ensure that Kaiser Permanente medical records meet all federal/state mandatory regulatory guidelines and KP internal controls.

Essential Responsibilities:
  • Maintain current knowledge of coding, federal and local regulations.
  • Provide coding audit outcomes to Coding management teams.
  • Develop and implement training when educational needs have been identified.
  • Work with the Revenue Cycle on other audit within the revenue service.
  • Work with the Coding management team to develop a remediation plan.
  • Work with the Coding leadership in development of policies and controls to support appropriate coding.
  • Perform other duties as assigned.
  • Identify gaps in documentation that facilitates coding issues.
  • Develop and preform audits to help determine and validate documentation and coding issues and gaps, analyzes audit results and identifies patterns, trends and variations in coding and documentation practices and make recommendations for improvement.

Basic Qualifications:

Experience
  • Minimum three (3) years coding experience of applying diagnoses and procedure codes to medical records, including Medicare, Medicaid

Education
  • High School Diploma or General Education Development (GED) required.

License, Certification, Registration
  • Credential in one or more: Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), Certified Coding Specialist (CCS), Certified Coding Specialist-Physician (CCS-P), Certified Professional Coder (CPC), Certified Outpatient Coder (COC) required upon hire/transfer.
  • Must maintain above registration or certification status.

Additional Requirements:
  • Excellent problem solving and time management skills.
  • Excellent customer service skills.
  • Knowledge of ICD-10-CM and CPT coding and clinician documentation.
  • Knowledge in both inpatient and outpatient medical coding.
  • Excellent interpersonal communication skills (written and verbal) to deal effectively in delicate, sensitive and/or complex situations with a wide variety of influential internal and external parties.
  • Knowledge of governmental coding regulations and areas of scrutiny for potential areas of risk for fraud and abuse.

Preferred Qualifications:
  • A thorough working knowledge of disease processes, diagnostic and surgical procedures, ICD-10CM and CPT coding applications, and HIM department responsibilities of government regulations and areas of scrutiny for potential fraud and abuse.
  • Current credential in one or more of the following: Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), Certified Coding Specialist (CCS), Certified Coding Specialist-Physician (CCS-P), AHIMA ICD 10 trainer
  • Experience with Microsoft Office, including Access, Excel, Word, and PowerPoint.
  • Bachelor's Degree or Associates Degree in Health Information Management Certified Coding Specialist (CCS), Certified Coding Specialist-Physician (CCS-P), OR four (4) years of experience in lieu of a preferred degree.
  • Minimum two (2) years in performing peer review audits and quality performance measures.
  • Minimum five (5) years applying diagnoses and procedure codes to inpatient and outpatient medical records, including Medicare, Medicaid, and third-party payor billings.
  • Working knowledge of the Encoder, EpicCare, and KARE systems.

PrimaryLocation : Oregon,Clackamas,Regional Process Center
HoursPerWeek : 40
Shift : Day
Workdays : Mon, Tue, Wed, Thu, Fri
WorkingHoursStart : 08:00 AM
WorkingHoursEnd : 04:30 PM
Job Schedule : Full-time
Job Type : Standard
Employee Status : Regular
Employee Group/Union Affiliation : NUE-NW-01|NUE|Non Union Employee
Job Level : Entry Level
Job Category : Accounting, Finance & Actuarial Services
Department : Portland Regional Process Ctr - Med Rcds-Coding Operations - 1008
Travel : No
Kaiser Permanente is an equal opportunity employer committed to a diverse and inclusive workforce. Applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy), age, sexual orientation, national origin, marital status, parental status, ancestry, disability, gender identity, veteran status, genetic information, other distinguishing characteristics of diversity and inclusion, or any other protected status.