Documentation and Coding Consultant 1

The Documentation and Coding Consultant 1 provides training, consultation, review, and feedback to clinicians on their medical service documentation and coding to ensure KPNW receives appropriate reimbursement and conforms to applicable guidelines and regulations.

This is a hybrid position that is a blend of working both remotely and in office. Must reside in the Northwest Service Region (Oregon or Washington).

Major Responsibilities:

• Provides expert consultation to specialists or primary care clinicians as assigned on coding and documentation education and questions.
• Researches new diagnostic and procedure codes utilizing CPT4, ICD-10 and HCPCS codes and assigns codes as appropriate, utilizing Consultant II, Consultant III, Supervisor expertise in decision making.
• Reviews and verifies component parts of the medical records to ensure the accuracy of diagnostic and therapeutic procedures is complete and conforms to CMS coding rules and guidelines.
• Provides face to face or virtual training to clinicians as requested.
• Analyzes and chooses educational presentation training points to emphasize; to ensure training is relevant and meets clinician needs appropriately to improve or maintain, consistent and accurate clinician code selection. Must be able to articulate and understand differences in clinician teaching methodology vs. coder teaching methodology.
• Performs periodic quality reviews of documentation and coding in KP HealthConnect/ EpicCare. Analyzes results and provides summary feedback to individual clinicians, making recommendations for improvement by providing coding education.
• Enters data into tracking tools to store professional coding service data.
• Collaborates with the Kaiser Permanente Health Connect team and informatics physician partners to develop and implement strategies to make appropriate documentation and coding more efficient for clinicians.
• Reviews and verifies information (such as POS, attending clinician) to make sure the transaction of medical data is complete and accurate.
• Participates in development of organizational procedures and updates of forms and manuals.

Minimum Education, Work Experience and Certifications:

• Associate of Science Degree in Health Information Technology or equivalent education or years of experience directly related to the duties and responsibilities.
• Minimum two (2) years progressive and in-depth multispecialty professional services coding experience in assignment of diagnostic and procedural coding or have completed the Documentation and Coding Consultant Apprentice training in the department.
• Pass internal coding test with 85% accuracy.
• Ability to conduct coding reviews and quality performance measures; prepare chart review reports with recommendations; and provide education and feedback to facilitate improvement of documentation and coding.
• Ability to evaluate, analyze, compute, and summarize mathematical statistics related to medical record reviews performed with ability to prepare materials to present findings, trends, outcomes.
• Ability to conduct coding reviews to evaluate quality performance measures and using the findings create written reports with recommendations; and then present education and feedback to facilitate improvement of documentation and coding.
• General understanding of medical terminology, pharmacology, body systems/anatomy, physiology, and concepts of disease processes.
• In-depth knowledge of ICD-10-CM, CPT and HCPCS and Evaluation and Management coding guidelines.
• Exemplary attention to detail and completeness with a thorough understanding of government rules and regulations and areas of scrutiny for potential areas of risk for fraud and abuse regarding coding and documentation.
• Abides by the Standards of Ethical Coding as set forth by AHIMA and AAPC.
• Ability to effectively deliver virtual training model with utilization of available meeting tools such as Teams, Zoom applications.
• Must be able to articulate and understand differences in clinician teaching methodology vs. coder teaching methodology.
• Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), Certified Coding Specialist Professional (CCS-P) from AHIMA or Certified Professional Coder (CPC) from AAPC.

Preferred Education, Work Experience and Certifications:

• Bachelors degree in Health Information Management or equivalent education and experience.
• Minimum five (5) years’ extensive coding experience with demonstrated ability to provide effective statistical analysis and analytical problem solving.
• Minimum two (2) years of multispecialty professional services coding experience using ICD-10, CPT and HCPCS, Evaluation and Management coding, including Medicare.
• Minimum two (2) years’ experience with project management functions and presenting education and training feedback to small and large groups.
• Comprehensive knowledge and proficiency in ICD-10, CPT and HCPCS coding.
• Advanced proficiency in use of Microsoft Office Suite of products and other software programs to document and manage audit data.

About Northwest Permanente:

We are the Permanente in Kaiser Permanente. Northwest Permanente is a self-governed, multi-specialty group of 1,500 physicians, clinicians, and administrative professionals caring for 630,000 members in Oregon and Southwest Washington. Together with Kaiser Foundation Health Plans and Kaiser Foundation Hospitals, we form Kaiser Permanente of the Northwest, an integrated health care program.  Kaiser Permanente is one of the nation's preeminent health care systems, a benchmark for comprehensive, integrated, value-based, and high-quality care.

Our Northwest Permanente administrative professionals enjoy a wide range of company sponsored benefits:

• 15% employer contribution to retirement programs, including pension
• 90% employer-paid health plan
• Tuition Reimbursement
• Child Care Benefits
• Flexible Work Schedules
• Paid Parental Leave
• Self-Care Days + Paid Time Off

Equal Opportunity Employer

Northwest Permanente is an equal opportunity employer committed to fair, respectful, and inclusive workplaces. Applicants will be considered for employment without regard to race, religion, sex, age, national origin, disability, veteran status, or any other protected characteristic or status.