Coding Technician III - Must Reside in Colorado

-May be entitled to translation/bilingual, shift or other wage premiums as governed by the applicable collective bargaining agreement. Please refer to the respective collective bargaining agreement for additional information on such wage premiums: https://www.lmpartnership.org/local-contracts. Job Summary:

Provides documentation review, coding, and data abstracting of medical service documentation to ensure that Kaiser Permanente Colorado receives appropriate reimbursement and conforms to applicable guidelines and regulations. Serves as a technical coder for all specialties.. Makes members/patients and their needs a primary focus of ones actions; develops and sustains productive member/patient relationships. Actively seeks information to understand member/patient circumstances, problems, expectations, and needs. Builds rapport and cooperative relationship with Providers. Considers how actions or plans will affect Providers; responds quickly to meet Providers needs and resolves coding problems.

Essential Responsibilities:

• This position, knows and complies with all Kaiser Permanente quality, safety, and emergency policies and procedures. Demonstrates quality and effectiveness in work habits and clinical practice in every interaction with patients, colleagues, providers, and leadership. Ensures patient safety in the preparation and provisioning of care related to but not limited to medications, procedures, infection prevention, fall prevention, including consistent use of two patient identifiers and procedural time outs. Reports safety hazards, accidents and incidents, and unsafe working conditions promptly.
• Required to research and assign Hospital surgical procedures (CPT-4), diagnosis (ICD-9CM), and procedures (CPT-4 and HCPCS) based on review of the entire medical record. Ability to research, analyze and/or review detailed and high complexity code edits and transactions within the Kaiser Permanente system.
• Provides additional support to the coding staff by resolving complex cases and issues.
• Contributes to the development and maintenance of specialty specific education materials.
• Maintains current knowledge of coding conventions, guidelines, updates, and regulations governing government and third party billing to ensure that Kaiser Permanente Colorado coding and documentation meets regulatory guidelines and audit standards, and results in appropriate reimbursement.
• Must meet and maintain departmental quality and production standards.
• Participates as needed in the testing and training of new system applications.
• Collaborates with clinical and non-clinical groups, to develop, implement and communicate specific coding and documentation guidelines that will fulfill the internal needs for complete and consistent clinical data.
• Serves as coding expert on various committees as requested.
• Supports compliance and Kaiser Permanents Code of Conduct by adhering to federal and state laws and regulations, accreditation and license requirements, by policies and procedures. Responds appropriately to observed fraud and abuse.
• Maintain a minimum of 6 months sustained 95% accuracy in current position for internal employees in the coding department.

Basic Qualifications:Experience

• Minimum of four (4) years of experience in outpatient or inpatient professional coding using ICD-10, CPT-4, and HCPCS.

Education

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

License, Certification, Registration

• Certified Professional Coder from American Academy of Professional Coders OR Certified Coding Specialist from American Health Information Management Association

Additional Requirements:

• Successful completion of coding and surgical coding assessment test.
• Ability to understand the clinical content of a health record including research and analysis of complicated records.
• Ability to abstract and assign all codes to surgical procedures performed.
• Above average written and communication skills with the ability to present, explain, and write information in a clear, concise, and organized format.
• Must be able to work with a variety of healthcare professionals at all levels.
• Ability to communicate with physicians and non-physician staff with a commitment to provide quality customer service. Working knowledge of medical specialties, including clinical conditions seen and procedures performed.
• Demonstrated ability to use spreadsheet and word processing applications.
• Must maintain all certifications required by this position.
• Demonstrated customer service skills, customer focus abilities and the ability to understand Kaiser Permanente customer needs.

Preferred Qualifications:

• Working knowledge of electronic medical record systems preferred.