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Outpatient Coder Specialist

Primary Location Wailuku, Hawaii Job Number 1316133 Date posted 10/15/2024
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Description:
Job Summary:

Under supervision, is responsible for assigning accurate diagnosis and procedure codes to the patients' health information records, for: Observation, Hospital Ambulatory Surgery, Complex Hospital Outpatient Visit {Cardiac Catheterization (Percutaneous Coronary Intervention) Lab, Interventional Radiology}, Emergency Departments, and other select OP records. This responsibility requires appropriate code assignment for physician-documented patient diagnoses, conditions and procedures; utilizing various coding classification schemes including ICD- 10CM (may include PCS), and HCPCS/CPT.
All work will be carried out in accordance with the: International Classification of Diseases - Official Coding Guidelines for coding and reporting as established by the Centers for Medicare and Medicaid Services (CMS) and the National Center for Health Statistics (NCHS); American Medical Association (CPT) National Correct Coding Initiative (NCCI), and Kaiser Permanente organizational/institutional coding directives. Ability to communicate with physicians in order to obtain clarification for diagnoses/procedures. Ability to understand the clinical content of the health record and abstract the data in the patient health information record data as well as perform other duties as assigned.



Essential Responsibilities:


  • 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.

Basic Qualifications:

Experience


  •  Minimum one (1) year of Certified Coding experience.


Education


  • High school diploma or General Education Diploma (GED) required.

  • Post high school coursework in medical records administration, anatomy, physiology and medical terminology.


License, Certification, Registration


  • Certified Coding Specialist OR Registered Health Information Technician OR Registered Health Information Administrator OR Certified Professional Coder



Additional Requirements:


  • 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.



Preferred Qualifications:


  • 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).

Primary Location: Hawaii,Wailuku,Maui Memorial - Wailuku Tower Scheduled Weekly Hours: 40 Shift: Day Workdays: Mon, Tue, Wed, Thu, Fri Working Hours Start: 08:00 AM Working Hours End: 04:30 PM Job Schedule: Full-time Job Type: Standard Employee Status: Regular Employee Group/Union Affiliation: S03|AFSCME|UNAC-UHCP-UNHCEH Job Level: Individual Contributor Department: MAUI MEMORIAL MEDICAL CENTER - HealthInforMgmt Administratn - 3601 Pay Range: $31.37 - $39.21 / hour The ranges posted above reflect the location in the job posting. The salary range may vary if you reside in a different location or state than the location posted. Travel: Yes, 10 % of the Time At Kaiser Permanente, equity, inclusion and diversity are inextricably linked to our mission, and we aim to make it a part of everything we do. We know that having a diverse and inclusive workforce makes Kaiser Permanente a better place to receive health care, a more supportive partner in our communities we serve, and a more fulfilling place to work. Working at Kaiser Permanente means that you agree to and abide by our commitment to equity and our expectation that we all work together to create an inclusive work environment focused on a sense of belonging and wellbeing.

Kaiser Permanente is an equal opportunity employer committed to a diverse and inclusive workforce. Applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy), age, sexual orientation, national origin, marital status, parental status, ancestry, disability, gender identity, veteran status, genetic information, other distinguishing characteristics of diversity and inclusion, or any other protected status. Submit Interest