Senior Medical Coding & Compliance Specialist

Kaiser Permanente; Pasadena (CA); On-site; USD 90,000 - 120,000; Full time

Job summary

Kaiser Permanente is seeking a Compliance Consultant IV, Medical Coding to independently review inpatient, outpatient, professional, and supplemental records to assign ICD-10-CM codes and related risk adjustment categories. The role ensures documentation supports coding and aligns with official guidelines, regulations, and policies.

The position emphasizes collaboration with internal and external stakeholders to develop audit reports, monitor compliance, and elevate regulatory concerns, while

Qualifications

• Minimum four (4) years medical coding experience.

Responsibilities

• Serves as a compliance subject matter expert relating to coding across all settings of care.
• Audits all lines of business for coding and develops audit result reports for regional staff and senior management.
• Develops and supports compliance initiatives and training.
• Assists with regulatory changes and implementation of designated changes.
• Coordinates with stakeholders to manage projects and compliance components.

Skills

Medical coding

Compliance

Risk adjustment

Auditing

Regulatory knowledge

Communication

Education

Bachelor's degree in Health Care Administration, Clinical, Law, Public Health, Business or related field

Tools

Risk adjustment coding platforms

Electronic medical records (EMR)

Job description

Kaiser Permanente is seeking a Compliance Consultant IV, Medical Coding to independently review inpatient, outpatient, professional, and supplemental records to assign ICD-10-CM codes and related risk adjustment categories. The role ensures documentation supports coding and aligns with official guidelines, regulations, and policies.

The position emphasizes collaboration with internal and external stakeholders to develop audit reports, monitor compliance, and elevate regulatory concerns, while