Medical Coder IV, Hospital-Based Coding

Kaiser Permanente Northwest; Portland (OR); On-site; USD 60,000 - 78,000; Full time

Job summary

Kaiser Permanente Northwest is seeking a Senior Medical Coder to lead and mentor a team in accurate inpatient and outpatient coding. The role emphasizes adherence to ICD-CM, CPT, HCPCS guidelines and collaboration with clinicians and administration to maintain compliance and timely submissions.

The position requires leadership experience, coding expertise, and a commitment to process improvements within a centralized medical records environment in Portland, OR.

Qualifications

• Minimum four (4) years of continuous inpatient and/or hospital coding experience.
• Minimum one (1) year of leadership experience.
• High School Diploma or GED or equivalent AND minimum six (6) years of coding experience.
• Certification: CSC or RHIA or RHIT required at hire.

Responsibilities

• Promotes learning in others and fosters cross-functional collaboration to achieve business outcomes.
• Autonomously completes assignments and supports projects with subject-matter expertise and process improvements.
• Guides team on coding documentation and ensures compliance with ICD-CM, CPT, and HCPCS coding guidelines.
• Supports updates to coding processes and regulatory compliance, and leverages data to improve coding operations.

Education

High School Diploma or GED

Job description

Job Summary

In addition to the responsibilities listed below, this position is also responsible for providing feedback to junior team members reviewing emergency, outpatient, ambulatory, and inpatient medical records to identify elements to be abstracted, as well as diagnostic and procedure codes.

• Promotes learning in others by proactively providing and/or developing information, resources, advice, and expertise with coworkers and members; builds relationships with cross-functional/external stakeholders and customers. Listens to, seeks, and addresses performance feedback; proactively provides actionable feedback to others and to managers. Pursues self-development; creates and executes plans to capitalize on strengths and develop weaknesses; leads by influencing others through technical explanations and examples and provides options and recommendations. Adopts new responsibilities; adapts to and learns from change, challenges, and feedback; demonstrates flexibility in approaches to work; champions change and helps others adapt to new tasks and processes. Facilitates team collaboration to support a business outcome.
• Completes work assignments autonomously and supports business-specific projects by applying expertise in subject area and business knowledge to generate creative solutions; encourages team members to adapt to and follow all procedures and policies. Collaborates cross-functionally and/or externally to achieve effective business decisions; provides recommendations and solves complex problems; escalates high-priority issues or risks, as appropriate; monitors progress and results. Supports the development of work plans to meet business priorities and deadlines; identifies resources to accomplish priorities and deadlines. Identifies, speaks up, and capitalizes on improvement opportunities across teams; uses influence to guide others and engages stakeholders to achieve appropriate solutions.
• Contributes to documentation and coding compliance by: guiding team members utilizing coding documentation and technology tools to ensure accurate coding in compliance with Official Coding Guidelines, ICD-CM, CPT, and HCPCS codes in the health care documentation system; monitoring team members and providing feedback regarding ongoing accurate documentation and coding of data; and overseeing that others can remain compliant with applicable federal, state, and local laws and regulations, The Principles of Responsibility, the Code of Conduct for Kaiser Permanente, internal policies and procedures, professional standards, and accreditation standards.
• Supports efforts to update coding processes and meet regulatory goals by: monitoring others as they perform analysis/review to assure the accuracy of current procedures and diagnosis codes upon request from various sources; partnering with upper management to plan methods for informing the team of internal resources (e.g., webinars, enterprise education team) to learn up-to-date knowledge of standards and regulatory requirements related to coding, documentation, and management compliance (federal, state, internal), and researching guidance for individual coding situations as necessary; leading process improvements for reference materials requiring revision based upon changes in code sets, industry standards, or compliance with state and federal rules; and meeting and maintaining department standards for productivity and quality.
• Contributes to data management and reporting by: facilitating strategy development for identifying and analyzing trends utilizing established documentation and coding criteria to support administrative planning and continuous improvement efforts; and using generated reports to recommend plan of action to leaders to correct discrepancies, prevent future coding errors, and improve coding operations.
• Completes medical coding by: providing insight to others translating clinical information into coded data and entering appropriate codes for diagnoses, procedures, and other services rendered, following coding guidelines for the most current version of the International Classification of Diseases Clinical Modification (ICD-CM), Current Procedural Terminology (CPT), and Healthcare Common Procedure Coding System (HCPCS) Level II for patient encounters, while maintaining own coding work; identifying and assigning appropriate codes for diagnoses, procedures, and other services rendered, and ensuring team members do the same; implementing process improvements for identifying and resolving coding issues through partnership with clinicians, department administration, and other coding staff based on review, coding guidelines, and queries or issues with practitioner-submitted medical codes to reduce denials and improve time to submission; and guiding others providing consultation to staff and care providers on all coding and documentation questions, and resolving complex issues.

Job Summary

In addition to the responsibilities listed below, this position is also responsible for providing feedback to junior team members reviewing emergency, outpatient, ambulatory, and inpatient medical records to identify elements to be abstracted, as well as diagnostic and procedure codes.

Essential Responsibilities

• Promotes learning in others by proactively providing and/or developing information, resources, advice, and expertise with coworkers and members; builds relationships with cross-functional/external stakeholders and customers. Listens to, seeks, and addresses performance feedback; proactively provides actionable feedback to others and to managers. Pursues self-development; creates and executes plans to capitalize on strengths and develop weaknesses; leads by influencing others through technical explanations and examples and provides options and recommendations. Adopts new responsibilities; adapts to and learns from change, challenges, and feedback; demonstrates flexibility in approaches to work; champions change and helps others adapt to new tasks and processes. Facilitates team collaboration to support a business outcome.
• Completes work assignments autonomously and supports business-specific projects by applying expertise in subject area and business knowledge to generate creative solutions; encourages team members to adapt to and follow all procedures and policies. Collaborates cross-functionally and/or externally to achieve effective business decisions; provides recommendations and solves complex problems; escalates high-priority issues or risks, as appropriate; monitors progress and results. Supports the development of work plans to meet business priorities and deadlines; identifies resources to accomplish priorities and deadlines. Identifies, speaks up, and capitalizes on improvement opportunities across teams; uses influence to guide others and engages stakeholders to achieve appropriate solutions.
• Contributes to documentation and coding compliance by: guiding team members utilizing coding documentation and technology tools to ensure accurate coding in compliance with Official Coding Guidelines, ICD-CM, CPT, and HCPCS codes in the health care documentation system; monitoring team members and providing feedback regarding ongoing accurate documentation and coding of data; and overseeing that others can remain compliant with applicable federal, state, and local laws and regulations, The Principles of Responsibility, the Code of Conduct for Kaiser Permanente, internal policies and procedures, professional standards, and accreditation standards.
• Supports efforts to update coding processes and meet regulatory goals by: monitoring others as they perform analysis/review to assure the accuracy of current procedures and diagnosis codes upon request from various sources; partnering with upper management to plan methods for informing the team of internal resources (e.g., webinars, enterprise education team) to learn up-to-date knowledge of standards and regulatory requirements related to coding, documentation, and management compliance (federal, state, internal), and researching guidance for individual coding situations as necessary; leading process improvements for reference materials requiring revision based upon changes in code sets, industry standards, or compliance with state and federal rules; and meeting and maintaining department standards for productivity and quality.
• Contributes to data management and reporting by: facilitating strategy development for identifying and analyzing trends utilizing established documentation and coding criteria to support administrative planning and continuous improvement efforts; and using generated reports to recommend plan of action to leaders to correct discrepancies, prevent future coding errors, and improve coding operations.
• Completes medical coding by: providing insight to others translating clinical information into coded data and entering appropriate codes for diagnoses, procedures, and other services rendered, following coding guidelines for the most current version of the International Classification of Diseases Clinical Modification (ICD-CM), Current Procedural Terminology (CPT), and Healthcare Common Procedure Coding System (HCPCS) Level II for patient encounters, while maintaining own coding work; identifying and assigning appropriate codes for diagnoses, procedures, and other services rendered, and ensuring team members do the same; implementing process improvements for identifying and resolving coding issues through partnership with clinicians, department administration, and other coding staff based on review, coding guidelines, and queries or issues with practitioner-submitted medical codes to reduce denials and improve time to submission; and guiding others providing consultation to staff and care providers on all coding and documentation questions, and resolving complex issues.

Minimum Qualifications

• Minimum four (4) years of continuous Inpatient and/or Hospital coding experience.
• Minimum one (1) year of experience in a leadership role with or without direct reports.
• High School Diploma or GED or equivalent AND minimum six (6) years of coding experience. OR Minimum six (6) years of coding experience and one (1) year of experience in a corporate or business office environment.
• Certified Coding Specialist required at hire OR Registered Health Information Administrator required at hire OR Registered Health Information Technician required at hire

Additional Requirements

• Knowledge, Skills, and Abilities (KSAs): Medical Terminology; Health Information Systems; Health Care Coding; Data Quality; Time Management; Medical Coding; Knowledge Management; Data Entry; Compliance Management; Quality Assurance and Effectiveness; Health Records; Maintain Files and Records; Prioritization

Preferred Qualifications

• N/A

Kaiser Permanente is an equal opportunity employer committed to fair, respectful, and inclusive workplaces. Applicants will be considered for employment without regard to race, religion, sex, age, national origin, disability, veteran status, or any other protected characteristic or status.

Primary Location:

Oregon,Portland,Kaiser Permanente Building

Scheduled Weekly Hours:

40

Shift:

Day

Workdays:

Mon, Tue, Wed, Thu, Fri

Working Hours Start:

08:00 AM

Working Hours End:

05:00 AM

Job Schedule:

Full-time

Job Type:

Standard

Worker Location:

Flexible

Employee Status:

Regular

Employee Group/Union Affiliation:

NUE-NW-02|NUE|Non Union Employee

Job Level:

Individual Contributor

Department:

Kaiser Permanente Building - Centralized Medical Records - 1001

Pay Range:

$43.84 - $56.69 / hour

Kaiser Permanente strives to offer a market competitive total rewards package and is committed to pay equity and transparency. The posted pay range is based on possible base salaries for the role and does not reflect the full value of our total rewards package. Actual base pay determined at offer will be based on labor market data, internal alignment, and a candidate's years of relevant work experience, education, certifications, skills, and geographic location.

Travel:

No

Work Setting:

Flexible

Worker location must align with Kaiser Permanente's Authorized States policy.

Kaiser Permanente is an equal opportunity employer committed to fair, respectful, and inclusive workplaces. Applicants will be considered for employment without regard to race, religion, sex, age, national origin, disability, veteran status, or any other protected characteristic or status.