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Coding Analyst, Compliance Guidelines - KPWA

Location Renton, Washington Job Number 945857 Date posted 07/08/2021
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Create documented coding educational materials to enable Kaiser Foundation Health Plan of Washington to meet and maintain compliant coding standards. Design, develop and implement coding educational materials for audiences that may include practitioners, ancillary clinical staff, Business Operations and CIS staff. Conduct needs assessments to determine priorities and best approaches to the delivery of coding educational materials. Develop policies and guidelines based on extensive research to meet the standards of coding compliance. Act as a coding resource to staff throughout Kaiser Foundation Health Plan of Washington. Interpret and articulate complex coding compliance issues. Decipher information from Medicare, Medicaid, Labor and Industries, CPT Assistant, Coding Clinic. etc. Design educational materials using a variety of approaches and resources utilizing adult educational principles. Evaluate the effectiveness of educational programs including compliant coding practices post education.

Essential Responsibilities:
  • Create coding guidelines, Gazette articles, coding job aids, FAQs, presentations, handouts, newsletters, and other materials. Materials created must be suitable for use in diverse settings from the classroom to web based applications etc that are consistent with current coding standards based on extensive research of complex coding issues; Exhibits excellent curriculum design skills.
  • Research complex coding issues so as to create accurate and compliant coding guidelines and educational materials; maintain up to date coding skills and knowledge; functions as a resource for coding issues; Performs extensive research of complex coding issues utilizing such sources as Medicare and Medicaid publications, CPT Assistant (official CPT publication of the AMA), Coding Clinic (official ICD-9 publication of the AHA and WHO); Able to communicate findings, exhibit collaboration, consultation and management of complex coding issues from start to finish.
  • Uses a variety of software to create coding materials, MS Word, PowerPoint, Excel, EpicCare, LastWord, etc.
  • Acts as a project manager, displaying effective teamwork and leadership skills, setting and meeting deadlines and objectives for projects assigned; leads and participates in committees as requested; effectively collaborates with CBO, Business Operations, CIS and the delivery system.
  • Perform performance analysis and needs assessments of complex coding compliance issues to determine coding guidelines and coding education materials that need to be created; develops, implements and evaluates effective strategies for the delivery of coding education tools; Performs post evaluation assessments to determine if coding compliance standards are being met; Displays excellent communication (written and spoken) and presentation skills; Able to communicate complex coding issues in an effective and efficient manner so as to obtain support from work group members and various audiences throughout Kaiser Foundation Health Plan of Washington.

  • Basic Qualifications:


    • Minimum five (5) years of progressively responsible experience in ICD-9-CM, CPT and HCPCS coding in a clinic setting including chart auditing experience. Progressively responsible roles in clinical, coding, business and training areas.


    • Bachelor's degree OR a minimum four (4) years of experience in a directly related field.

    • High School Diploma OR General Education Development (GED) is required.

    License, Certification, Registration

    • Coding Certification, CPC or CCS-P required at time of hire/transfer.


    Additional Requirements:

    • Presentation, customer service and interpersonal skills. Ability to interact effectively as a project manger. Conflict resolution and problem solving skills. Extensive computer skills and ability to learn new computer applications quickly and independently. Demonstrated decision-making ability. Project management skills. Knowledge of adult learning theory and various instructional approaches. In-depth knowledge of ICD-9-CM, CPT and HCPCS coding.

    • Knowledge of medical terminology and medical science and disease processes, anatomy and physiology.

    • Knowledge of health care billing and reimbursement, industry-standard billing rules, including Medicare, Medicaid, L&I and commercial insurance.

    • Knowledge of Medicare compliance issues and working knowledge of APCs and DRGs.

    • Demonstrated ability to implement up to date and compliant coding information in a complex clinical setting.

    • Experience in application of compliant coding principles, including Medicare compliance issues.

    *** Repost of #916279 ***


    Preferred Qualifications:

    • Seven (7) years of progressively responsible experience in ICD-9-CM, CPT and HCPCS coding in a multispecialty practice, hospital professional and hospital facility setting, including chart auditing experience. Demonstrated success working with delivery system staff including creating and delivering formal and informal educational and web based programs. Progressive experience in application of compliant coding principles including Medicare compliance issues. Progressive experience demonstrating ability to implement up to date and compliant coding information in a complex clinical setting.

    • Demonstrated experience in enterprise clinical information systems, e.g. EpicCare.

    • Demonstrated skills in project management including all related project management skills necessary to complete complex compliant coding research projects.

    • Knowledge of Medicare compliance issues and extensive knowledge of health care billing and reimbursement in a fee-for-service environment. Knowledge of industry-standard billing rules, including Medicare, Medicaid, L&I and commercial insurance. Knowledge of APCs and DRGs. Demonstrated skills in using enterprise clinical information systems, particularly EpicCare.


    • Bachelors degree in health care or education related major, i.e. RHIA or BSN.

    • Master's degree in health care, education or business related major.

    Primary Location: Washington,Renton,Renton Administration - Glacier Scheduled Weekly Hours: 40 Shift: Day Workdays: Mon, Tue, Wed, Thu, Fri, Working Hours Start: 08:00 AM Working Hours End: 04:00 PM Job Schedule: Full-time Job Type: Standard Employee Status: Regular Employee Group/Union Affiliation: NUE-WA-04|NUE|Non Union Employee Job Level: Individual Contributor Department: Renton Admin Glacier - Med Ofc Coding Educ_Qual Revw - 1130 Travel: No 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.

    External hires must pass a background check/drug screen. Qualified applicants with arrest and/or conviction records will be considered for employment in a manner consistent with federal and state laws, as well as applicable local ordinances, including but not limited to the San Francisco and Los Angeles Fair Chance Ordinances.