Kaiser Permanente

Kaiser Permanente in Portland, OR is seeking an experienced coder for a documentation review and coding position focused on accurate claim submission and regulatory compliance. The role requires two years in healthcare, with at least one year of professional coding experience and certification credentials. You will review documentation, stay current with guidelines, and support audits and complex coding tasks. #J-18808-Ljbffr

Job Summary: Must reside in Northern California Under direct supervision, the Hospital Outpatient Coder is responsible for the accurate coding and abstracting of diagnoses, conditions and procedures from medical record documentation for Hospital Ambulatory Surgery (HAS), Home Health/Hospice (if applicable), Observation (OBS) and Hospital complex Outpatient Visit (CHOY) including capture of codes for outpatient services that require monitored anesthesia and conscious sedation. Working from appropriate documentation, assign the appropriate codes and modifiers with ICD-CM, CPT and HCPCS Level II codes. All work must be 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. Essential...

A leading healthcare provider in California is seeking a coding professional to assign and validate diagnosis and procedure codes for patient health records. This role involves understanding clinical documentation, ensuring compliance with coding standards, and collaborating with physicians for accurate coding. The ideal candidate will maintain high coding accuracy standards and work in a team-oriented environment. This position requires on-site presence for up to one year. #J-18808-Ljbffr

Job Summary: In addition to the responsibilities listed below, this position is also responsible for reviewing emergency, outpatient, and ambulatory medical records to identify elements to be abstracted, as well as diagnostic and procedure codes, and beginning to review inpatient records. Essential Responsibilities: * Pursues effective relationships with others by sharing resources, information, and knowledge with coworkers and members. Listens to, addresses, and seeks performance feedback. Pursues self-development; acknowledges strengths and weaknesses based on career goals and takes appropriate development action to leverage / improve them. Adapts to and learns from change, challenges, and feedback; demonstrates flexibility in approaches to work. Assesses and responds to the needs of others to support a business outcome. * Completes work assignments by applying up-to-date knowledge in subject area to meet deadlines; follows procedures and policies, and applies data and...

Job Summary: In addition to the responsibilities listed below, this position is also responsible for leveraging foundational knowledge of imaging to ensure day-to-day operations are compliant with all relevant regulations; auditing quality and safety metrics and key performance indicators (KPIs) as required by regulatory bodies; aligning protocols and processes with guidelines and best practices; and identifying and escalating technology and equipment issues that arise. Essential Responsibilities: Recommends developmental opportunities for others; builds collaborative, cross-functional relationships. Solicits and acts on performance feedback; provides team members with feedback; and mentors and coaches to drive performance improvement. Pursues professional growth; provides training and development to talent for growth opportunities; supports execution of performance management guidelines and expectations. Implements, adapts, and stays up to date with organizational change,...

Kaiser Permanente in Oakland, CA is seeking an Inpatient Coder to accurately code and abstract inpatient cases using ICD-CM, ICD-PCS, CPT and HCPCS. The role involves reviewing medical records, ensuring correct code sequencing, DRG assignment, and data abstraction to support compliant reporting. Under supervision, you will collaborate with physicians to clarify documentation, maintain productivity/quality standards, and uphold confidentiality. #J-18808-Ljbffr

Job Summary Under direct supervision, the Inpatient Coder is responsible for the accurate coding and abstracting of inpatient cases or services (diagnosis, conditions and procedures) from medical record documentation. Assign codes and modifiers using the appropriate version of ICD-CM, ICD-PCS, CPT and HCPCS as well as other specialty systems as required by diagnostic category. The Inpatient Coder is expected to code and abstract Observation (OBS), Hospital Ambulatory Surgery (HAS), Emergency Department (ED), and complex Hospital Outpatient Visit (CHOY) services when needed. All work must be 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, ICD-PCS, CPT and HCPCS code book, CPT Assistant, NCCI Edits, CMS, OSHPD and Kaiser Permanente organizational and institutional coding guidelines. Essential Responsibilities Coding and...

Job Summary:Leads the development of applicable policies and procedures for audit and process improvement projects. Identifies an appropriate plan for correcting deviations from expected quality control results. Promotes the use of strategies to ensure that tests are performed properly and results are verified before being shared. Monitors the management of specimens to ensure they are collected and processed according to established time and quality standards. Removes obstacles that prevent adherence to all requirements related to the recruitment, processing, testing, storage, and distribution of materials and samples. Researches, reports, and responds to technical and/or non-technical deficiencies in regulatory/accreditation inspection processes. Implements new testing methodologies, processes, and technology that have the potential to improve service, quality and/or efficiency. Leads the development and implementation of technical and/or non-technical training materials while...

Job Summary:Supervises team to review and request primary source information and verifications. Proactively identifies, suggests improvements to, and provides resolution for complex gaps in vendor relationships. Serves as an escalation point of contact for external queries regarding practitioner status. Evaluates applications and supporting highly complex documents. Guides team to conduct improvements to credentialing and privileging processes. Guides and supervises team to evaluate complex practitioner sanctions. Participates in surveys and audits of credentialing entities. Facilitates and implements strategic initiatives cost-effective due process. Identifies and provides leadership to resolve adverse actions/issues. Leads and evaluates audits of data between different departments. Conducts and supervises the facilitation and orientation and training to newly appointed physician leaders. Develops highly complex informational documents. Maintains working relationships with key...

Job Summary :Ensures all technical aspects of the assignment of diagnostic and procedure coding is carried out in accordance with established standards and is in compliance with CMS, NCQA, other regulatory agencies, third party payers and Kaiser Permanente policy.Function includes, but is not limited to working charge review work queues, other forms of charge submissions and querying providers to ensure the completeness and accuracy of coding of internal services performed.Essential Responsibilities :Responsible for reviewing primarily medical and ancillary type workques charge sessions within KP Health connect and applying coding principles for correct coding.Research, code, and / or data enter encounters that are supported by KPHC with the Charge capture tool.Review all other charge sessions submitted via paper encounters, physician in baskets and other various methods to ensure correct coding principles have been applied.Query providers for clarification of incomplete or...

Job Summary :Ensures all technical aspects of the assignment of diagnostic and procedure coding is carried out in accordance with established standards and is in compliance with CMS, NCQA, other regulatory agencies, third party payers and Kaiser Permanente policy.Function includes, but is not limited to working charge review work queues, other forms of charge submissions and querying providers to ensure the completeness and accuracy of coding of internal services performed.Essential Responsibilities :Responsible for reviewing primarily medical and ancillary type workques charge sessions within KP Health connect and applying coding principles for correct coding.Research, code, and / or data enter encounters that are supported by KPHC with the Charge capture tool.Review all other charge sessions submitted via paper encounters, physician in baskets and other various methods to ensure correct coding principles have been applied.Query providers for clarification of incomplete or...