Outpatient Coder Specialist; Maui Health

Kaiser Permanente; Delta (CO); On-site; USD 60,000 - 90,000; Full time

Job summary

Kaiser Permanente seeks an Outpatient Coder Specialist for Maui Health in Wailuku, HI. Under supervision, you will assign accurate diagnosis and procedure codes for ambulatory records, using ICD-10-CM/PCS, CPT4, and HCPCS guidelines. You will query physicians when documentation is unclear and ensure HIPAA compliance.

Role requires knowledge of coding guidelines, accuracy targets (95% accuracy, 98% completeness), and interaction with care teams to maintain coding quality.

Qualifications

• Minimum one year of Certified Coding experience.
• High school diploma or GED; post-high school coursework in medical records administration, anatomy, physiology and medical terminology.
• Certified Coding Specialist OR RHIT OR RHIA OR CPC.
• Experience with ICD-10, CPT4, HCPCS coding and related documentation.
• Preferred: three consecutive years as Certified Hospital Coder and AHIMA certification.

Responsibilities

• Review patient health information to assign codes for diagnoses and procedures.
• Sequence codes for APC assignment using coding conventions.
• Consult with care providers; resolve documentation queries.
• Abstract data into electronic health records with accuracy.
• Ensure timely coded records per regulatory guidelines and quality targets.
• Maintain HIPAA compliance and participate in coding education sessions.
• Collaborate with team on coding questions and issues.

Skills

ICD-10 coding

CPT4 coding

HCPCS coding

Physician communication

Attention to detail

Education

High school diploma or GED

Post-high school courses in medical records administration, anatomy, physiology, medical terminology

AHIMA certification or equivalent (e.g., CCS, RHIT, RHIA, CPC)

Tools

Microsoft Office

Job description

Job Summary

Under supervision, is responsible for assigning accurate diagnosis and procedure codes to the patients health information records, for: Observation, Hospital Ambulatory Surgery, Complex Hospital Outpatient Visit {Cardiac Catheterization (Percutaneous Coronary Intervention) Lab, Interventional Radiology}, Emergency Departments, and other select OP records. This responsibility requires appropriate code assignment for physician-documented patient diagnoses, conditions and procedures; utilizing various coding classification schemes including ICD- 10CM (may include PCS), and HCPCS/CPT.

All work will be carried out in accordance with the: International Classification of Diseases - Official Coding Guidelines for coding and reporting as established by the Centers for Medicare and Medicaid Services (CMS) and the National Center for Health Statistics (NCHS); American Medical Association (CPT) National Correct Coding Initiative (NCCI), and Kaiser Permanente organizational/institutional coding directives. Ability to communicate with physicians in order to obtain clarification for diagnoses/procedures. Ability to understand the clinical content of the health record and abstract the data in the patient health information record data as well as perform other duties as assigned.

Essential Responsibilities

• Upholds and maintains Maui Health Systems Policies and Procedures, Principles of Responsibilities and all applicable state, federal and local laws. Reviews patient health information record to: identify and assign appropriate codes for diagnoses, procedures, and other services rendered.
• Appropriately assign and sequence codes for diagnoses, procedures and other services as needed for proper Ambulatory Payment Classification (APC) assignment, utilizing the applicable coding conventions.
• Serves as a consultant to care providers.
• Identifies discrepancies, potential quality of care, and billing issues. Research, analyzes, recommends and facilitates plan of action to correct discrepancies and prevent future coding errors.
• Interacts with physicians through established query process in order to clarify documentation supporting accurate patient diagnostic and procedure coding.
• Abstracts patient information into the computerized systems, in a manner ensuring the accuracy and integrity of the data.
• Ensures timely coded record availability according to regulatory guidelines, by meeting established coding and abstracting productivity standards. Ensures quality standards by meeting the established 95% coding accuracy and 98% completeness quality standards.
• Maintains and complies with HIPAA policies and procedures for privacy and confidentiality of all patient records.
• Attends and participates in selected national, regional and coding educational sessions. Works collaboratively with others on coding questions and issues.
• Demonstrates knowledge of system security, by complying with KP Electronic Assets Usage Policy.
• Maintains courteous and cooperative relations when interacting with others.
• Performs other duties as assigned.

Basic Qualifications

• Experience
• + + Minimum one (1) year of Certified Coding experience.
• Education
• High school diploma or General Education Diploma (GED) required.
• Post high school coursework in medical records administration, anatomy, physiology and medical terminology.
• License, Certification, Registration
• + Certified Coding Specialist OR Registered Health Information Technician OR Registered Health Information Administrator OR Certified Professional Coder
• Additional Requirements
• Demonstrated competence with personal computers, networks, and Microsoft Office.
• Experience with International Classification of Diseases (ICD-10), Current Procedure Terminology (CPT4), and Healthcare Common Procedure Coding System (HCPCS) coding system, and other related documentation requirements.
• Demonstrated ability to understand clinical content of a health record.
• Preferred Qualifications
• Minimum three (3) consecutive years of experience as a Certified Hospital Coder.
• Previous experience of coding in a hospital license space.
• Successful completion of Certified Coding Specialist Program through American Health Information Management Association (AHIMA).

Company

KAISER

Title

Outpatient Coder Specialist; Maui Health

Location

Wailuku, Hawaii

ReqNumber

1402494

Background Check

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.

Equal Opportunity

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.