Outpatient Facility Medical Coder (WA/OR Remote)

Kaiser Permanente; Portland (OR); Remote; USD 50,000 - 70,000; Full time

Job summary

A leading healthcare organization is seeking a Coding Specialist to accurately assign diagnosis and procedure codes to patient records across various departments. The role requires effective communication with physicians and adherence to coding standards and guidelines. Candidates must have a high school diploma and relevant coding experience, along with proficiency in medical terminology and coding principles.

Qualifications

• Minimum two years of experience in a related coding field.
• Must pass a coding skill test with at least 75% accuracy.

Responsibilities

• Assign accurate diagnosis and procedure codes to patients' health records.
• Perform chart analysis to ensure completeness and accuracy in coding.
• Utilize resources for coding guideline research.

Skills

Medical terminology

Analytical skills

Communication

Time management

Education

High School Diploma or GED

Tools

EpicCare

CBCT

OPTUM 360 EncoderPRO

Job description

Job Summary:

To independently and efficiently perform responsibilities by assigning accurate diagnosis and procedure codes to patients' health information records across various departments such as Emergency Department (ED), Ambulatory Surgical Center (ASC), Hospital Ambulatory Surgical Center (HAS), Observations (OBS), Inpatient (IP), and others. Maintain performance standards in quality and productivity for ICD-10-CM, ICD-10-PCS, and HCPCS/CPT systems, adhering to established guidelines from CMS, NCHS, AMA, NCCI, UHDDS, Medicaid, and Kaiser Permanente directives. Communicate effectively with physicians for clarifications, understand clinical content, and abstract data accordingly. The role requires on-site training for one week or until departmental expectations are met.

Essential Responsibilities:

• Proficient in medical record review and translating clinical information into coded data, including validation of CAC assignments.
• Utilize systems like CBCT and OPTUM 360 EncoderPRO for analyzing and maintaining coding accuracy for professional and facility services, accessing patient data through electronic systems such as EpicCare.
• Abstract and enter clinical data as needed by the organization.
• Identify and assign principal diagnosis and procedure codes, ensuring proper sequencing for APC, MS-DRG, and APR-DRG classifications.
• Demonstrate knowledge of CMS HCC Risk Adjustment coding.
• Perform chart analysis to identify documentation gaps, verify chart details, and ensure completeness and accuracy in coding, maintaining a productivity and quality standard of 95%.
• Use resources like Coding Clinic and CPT Assistant for coding guideline research.
• Report coding concerns to supervisors and utilize the query process when necessary.
• Assist in reducing coding errors and stay current with coding regulations and updates through ongoing education.
• Participate in special projects, maintain confidentiality, and foster effective communication and teamwork.
• Review ICD-10 guidelines and participate in coding education sessions and organizational procedures development.
• Attend national and regional coding education sessions and perform additional duties as assigned.

Basic Qualifications:

• Minimum two years of experience in a related coding field or 18 months in the Kaiser Apprentice program.
• High School Diploma or GED.

License, Certification, Registration:

• Registered Health Information Technician, Registered Health Information Administrator, or Certified Coding Specialist.

Additional Requirements:

• Experience with EMR systems and intermediate computer skills.
• Advanced knowledge of disease processes, procedures, ICD-10-CM, ICD-10-PCS, HCPCS/CPT, and healthcare regulations.
• Proficiency in medical terminology, pharmacology, and coding principles.
• Fluency in English with strong communication skills.
• Effective time management, organizational, and analytical skills.
• Ability to handle a significant workload under pressure with minimal supervision.
• Adherence to AHIMA's Ethical Coding Standards.
• Must pass a coding skill test with at least 75% accuracy.