E&M/Specialty Coder

Kaiser Permanente • Stockton, CA

246d • Remote

About The Position

Under direct supervision, the E&M/Specialty Coder is responsible for accurate coding of professional services (diagnoses, conditions and procedures) from medical record documentation in a hospital setting. Working from appropriate documentation in the medical record, assigns codes and modifiers with ICD-CM, CPT and HCPCS Level II codes. All work is performed in accordance with the rules, regulations and coding conventions of ICD-CM Official Guidelines for Coding and Reporting, Coding Clinic published by the American Hospital Association, the ICD-CM, CPT and HCPCS code book, CPT Assistant, NCCI Edits, OSHPD and Kaiser Permanentes organizational and institutional coding guidelines.

Requirements

• Minimum two years, within the last three years, certified professional coding experience.
• High School Diploma or GED.
• Completion of classes in medical terminology, anatomy, physiology, current ICD CM and CPT coding conventions, and disease process from an accredited program.
• Certified Coding Specialist - Physician Based OR Certified Professional Coder OR Registered Health Information Technician.
• Achieve a minimum score of 80% on the E&M/Specialty Coder test.
• Basic knowledge of and use of computer keyboard.
• Must be able to meet production and quality standards established for the position.
• Demonstrated knowledge of anatomy, physiology, medical terminology and disease processes.
• Demonstrated ability to understand the clinical content of a health record.
• Demonstrated ability to communicate with physicians regarding coding and documentation requirements.
• Basic knowledge of reimbursement methodologies and conventions.
• Knowledge of rules and guidelines for current coding classifications.
• Practical knowledge of hospital and/or physician clinic based revenue cycle.
• Practical knowledge of professional series coding and billing in a multi-specialty environment.
• Practical knowledge of government and other payer coding, billing and collection rules and regulations.
• Must maintain current coding credential and perform associated Continuing Education Units.
• Must abide by the AHIMA and/or AAPC code of ethics.
• Must be willing to work in a Labor Management Partnership environment.

Responsibilities

• Review Medical Records to identify diagnoses/procedures.
• Under supervision, codes all diagnostic and operative information from the medical record using ICD-CM, CPT and HCPCS coding classification systems.
• Verifies and abstracts all medical data from the record to assign appropriate codes for various hospital settings.
• Corrects data as appropriate.
• Review Medical Records to resolve Ingenix and HealthConnect Coding Edits.
• Identify and resolve coding related edits by reviewing the medical record.
• Organizes and prioritizes all work to ensure compliance with regulatory, billing and SOX requirements.
• Interacts with clinical contacts to clarify and promote accurate documentation of patient diagnostic and procedural information.
• Enters patient information into the computerized medical record and billing systems.
• Ensures timely data completion by meeting coding/abstracting productivity/quality standards.
• Provides feedback to monitor service provider and line of business compliance with regulatory requirements.
• Maintains and complies with policies and procedures for confidentiality of all patient records.
• Acts as a resource person to other departments regarding coding questions and issues.
• Performs other duties as assigned.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Industry: Ambulatory Health Care Services
• Education Level: High school or GED