Medical Coding Reviewer 1

Mid-Atlantic Permanente Medical Group PC•Washington, DC

3d•$62,712 - $78,390•Remote

About The Position

Mid-Atlantic Permanente Medical Group (MAPMG) is hiring a Medical Coding Reviewer I for its Medical Coding team. This is a full-time remote position based out of the regional office in Washington, D.C. The role reports to the Director of Retrospective Coding Operations. The Medical Coding Reviewer I conducts data quality monitoring of physician documentation to validate accurate code assignment in accordance with official coding guidelines, clinical documentation, and regulatory requirements. The reviewer examines medical records, identifies potential documentation risks, and applies ICD-10-CM and CPT coding standards to support coding accuracy, quality assurance, analysis, and training activities. The role also uses Kaiser Permanente HealthConnect (EPIC) to gather and analyze data and contribute to appropriate action plans. Candidates must live in or be willing to relocate to the Washington, D.C. metropolitan area and be able to commute to Washington, D.C. as needed. Documentation for the influenza vaccine is a condition of employment. External hires must pass a background check and drug screening.

Requirements

High school diploma or General Education Development (GED) with equivalent experience.
Certification in at least one of the following: Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), Certified Coding Specialist (CCS), Certified Professional Coder (CPC), or Certified Risk Adjustment Coder.
At least one year of experience coding based on Coding Clinical Guidelines.
Ability to interpret and apply federal and state regulations and coding and billing requirements.
Ability to maintain the confidentiality of physician, patient, and patient account information.
Strong interpersonal, written, verbal, and presentation skills.
Ability to work effectively in a team environment and remain flexible based on department and physician scheduling needs.
Must be able to commute to Washington, D.C., as needed.
Must currently live in or be willing to relocate to the Washington, D.C. metropolitan area.
Must provide documentation for the influenza vaccine as a condition of employment.

Nice To Haves

Bachelor’s degree in Business Administration, Health Care, Public Health, Finance, Business Medical Records Technology, or a related field.
Three years of coding experience involving inpatient and outpatient professional services.
Three years of experience conducting medical record audits.

Responsibilities

Review medical records using primary source materials, including CMS and ICD-10 coding guidelines, to determine accurate assignment of diagnoses and procedures.
Apply ICD-10-CM and CPT codes based on documentation in the Electronic Medical Record (EMR).
Ensure coding practices adhere to established Standards of Ethical Coding.
Document review determinations in regional databases to support quality assurance, regional analysis, and training activities.
Identify potential documentation risk areas through medical record reviews.
Maintain accuracy and consistency in selecting diagnosis and procedure codes while meeting established productivity expectations.
Identify operational processes that may hinder accurate encounter data capture.
Use Kaiser Permanente HealthConnect (EPIC) to gather and analyze data, interpret findings, and contribute to developing appropriate action plans.

Benefits

Competitive compensation package.
100% employer-funded medical and dental insurance premiums for employees and families, effective on the first day of employment.
Generous paid time off, including vacation, holidays, and sick leave.
Maternity and parental leave.
Pension plan.
401(k) retirement plan with employer contributions.
Life insurance.
Short-term disability coverage.
Long-term disability coverage.
Education reimbursement.