Supervises all activities related to physician/provider coding education for outpatient & inpatient professional fee services. Maintains a close working relationship w/ the Medical Group & Operations management to support provider coding accuracy that is consistent w/ industry standards & in compliance w/ coding guidelines. Accountable for developing/maintaining a culture of service, financial discipline, compliance, ethics & integrity. Maintains knowledge of & assures departmental compliance w/ KP's Principles of Responsibility, policies & procedures, applicable regulatory requirements & accreditation standards. Responds appropriately to observed fraud or abuse.
Essential Functions:
- Supervises the day to day activities of the Provider Coding Education Program & supports a high level of coding accuracy
- Provides reporting on provider education results for multiple audiencesDevelops the Coding Education staff
- Assesses & maintains impact of current compliance activities & evaluates risk factors of coding & documentation practices
- Uses understanding of interrelationships among systems across functional areas to redesign processes, improve efficiency, & ensure optimal results for the future
- Monitors changes in laws, regulations, & coding & documentation standards as they apply to the Coding Education Department & Providers of KP Colorado
- Participates in Committees or Workgroups as required
- Abides by the Standards of Ethical Coding as set forth by the American Health Information Management Association & adheres to official coding guidelines
- Supervises direct reports; including interviewing, selecting, training, motivating, evaluating, counseling, disciplining & terminating in compliance w/ EEO/AA goals & personnel policies of the organization
Qualifications:
Basic Qualifications:
- 5 years of progressively responsible experience in a coding environment, including 2 years of leadership/supervisory experience
- Bachelor's degree in business administration, health care administration, health information management, or related field or equivalent experience
- AAPC or AHIMA Coding Certification required
- Experience in developing educational materials & conducting training & education sessions a multi-specialty setting is required
- Must pass internal coding assessment test
- Must be able to work in partnership w/ Labor & Medical Group to assure compliance w/ documentation & coding guidelines is achieved, resulting in the accurate representation of services provided & diagnoses reported
- Proven analytical & organizational ability
- Proven communication & presentation skills, demonstrated experience w/ provider auditing in CPT-4 (including E&M), ICD-9-CM, & HCPCS as well as knowledge of Medicare Part C Reimbursement (HCC Model)
- Previous experience providing expert consultation to clinicians
- Strong written, verbal & interpersonal communication skills required
- Must maintain all certifications required of this position
- RHIA or RHIT certification considered
Preferred Qualifications:
- Project management experience preferred
- Experience w/ electronic medical record preferred
External hires must pass a background check/drug screen.
We are proud to be an equal opportunity/affirmative action employer.