THREE OPEN POSITIONS
Ensures all technical aspects of the assignment of diagnostic and procedure coding is carried out in accordance with established standards and is in compliance with CMS, NCQA, third party payors, , other regulatory agencies and Kaiser Permanente policy. Functions includes, but are not limited to working charge review work queues for internal and external surgical services, acute and sub-acute inpatient professional services and performs health record audits as needed. These activities are performed to ensure the completeness and accuracy of coding clinical diagnoses, surgical and therapeutic procedures.
Essential Functions:
- Review and code workques, charge review session including all medical, surgical and sub-specialty services within the workques as assigned by applying coding principles for correct coding, including sequencing.
- Query providers for clarification of incomplete or ambiguous documentation as appropriate and monitor inbasket messages for timely responses.
- Evaluates and identifies front end and back end error trends for training needs and brings them to the attention of the supervisor.
- Communicate and participates in departmental meetings and initiatives involving Coding and the Revenue Cycle Enhancement process.
- Performs other duties as assigned or required.
Qualifications:
Basic Qualifications:
Two years of experience in a healthcare setting with proficiency in medical terminology is required.
- One (1) year of coding experience is required.
- Two (2) years of customer service experience is required.
- High school diploma is required.
- CPC or CCS-P is required.
- New Hire: Successful completion of Assessment of Critical Coding Skills, 80% or higher passing score.
- Annually: Successful completion of Assessment of Critical Coding Skills, 80% or higher passing score.
- Two (2) years of knowledge in coding practices is required.
- Two (2) years of knowledge of compliance and regulatory requirements is required.
Preferred Qualifications
Ability to work with and maintain confidentiality of physician, patient, patient account and personnel data is preferred.
Effective verbal and written communication skills, as well as, strong interpersonal skills is preferred.
Ability to effectively abstract medical information to determine the correct data is preferred.
Strong data management skills including proficiency in MS Office applications is preferred.
External hires must pass a background check/drug screen.
We are proud to be an equal opportunity/affirmative action employer.