Job Summary:

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 payers, other regulatory agencies and Kaiser Permanente policy. Functions includes, but are not limited to working charge review work queues for internal services, to include: clinical diagnoses and therapeutic procedures.

Essential Responsibilities:

• Review and code workques, charge review session including all internal 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.

  Basic Qualifications:

  Experience

• Minimum two (2) years of experience in a healthcare setting with proficiency in medical terminology is required.

• Minimum two (2) year of coding experience is required.

• Minimum two (2) years of customer service experience is required.

• Minimum two (2) years of knowledge in coding practices is required.

• Minimum two (2) years of knowledge of compliance and regulatory requirements is required.

  Education

• Completion of coursework that includes anatomy and physiology, pathophysiology, pharmacology, medical terminology, reimbursement methodology, intermediate/advanced ICD diagnostic/procedural and CPT coding.

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

  License, Certification, Registration

• Coding Specialist Certificate - Physician Based OR Professional Coder Certificate

  Additional Requirements:

• New Hire: Successful completion of Assessment of Critical Coding Skills and 80% or higher passing score.

• Annually: Successful completion of Assessment of Critical Coding Skills and 80% or higher passing score.

• Ability to work with and maintain confidentiality of physician, patient, patient account and personnel data.

• Effective verbal and written communication skills, as well as, strong interpersonal skills.

• Ability to effectively abstract medical information to determine the correct data.

  Preferred Qualifications:

• Strong data management skills including proficiency in MS Office applications is preferred.

COMPANY: KAISER

TITLE: Certified Professional Coder 2 - Remote in MD, DC, or VA

LOCATION: Hyattsville, Maryland

REQNUMBER: 1231182

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.