Outpatient Coder Specialist

Kaiser Permanente-posted about 1 year ago
Full-time
Wailuku, HI
Ambulatory Health Care Services
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The Outpatient Coder Specialist is responsible for accurately assigning diagnosis and procedure codes to patients' health information records across various outpatient services, including observation, ambulatory surgery, and emergency departments. This role requires adherence to coding guidelines and effective communication with healthcare providers to ensure accurate documentation and coding practices.

  • 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.
  • Minimum one (1) year of Certified Coding experience.
  • High school diploma or General Education Diploma (GED) required.
  • Post high school coursework in medical records administration, anatomy, physiology and medical terminology.
  • Certified Coding Specialist OR Registered Health Information Technician OR Registered Health Information Administrator OR Certified Professional Coder.
  • 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.
  • 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).
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