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Job Field: Legal Jobs
Location: PORTLAND, WA
Salary: $-
Job Type: Part Time

JOB SUMMARY:

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               <td align="left"><font style="font-size: 100%;">Title: Coding Review Specialist<BR>Location: Clackamas, OR<BR>Under limited supervision, the HIM Coding Review Specialist will coordinate, monitor and audit documentation and coding of inpatient and/or outpatient services in all applicable health care settings. Audits will focus on correct assignment of CPT, ICD-9-CM, HCPCS codes; Medicare Risk adjustment, and clinician documentation to ensure that KP is compliant with all regulatory guidelines and internal controls. Audits will encompass internal practitioners, contracted practitioners, coders, internal facilities and contracted facilities.<BR><BR>The HIM Coding Review Specialist will analyze audit results, identify patterns, trends or variations in coding and documentation practices and make recommendations for improvement. When necessary, HIM Coding Review Specialist will initiate corrective action plan to ensure resolution of problem areas identified during auditing and monitoring activity. This position will serve as a liaison with HIM staff, revenue cycle, clinicians, and other regional departments as appropriate. This position will travel to multiple facilities within Portland Metro area and WA.<BR><BR>Essential Functions:<BR>- Conduct medical record inpatient and outpatient coding audits to ensure correct assignment of ICD-9-CM, CPT, HCPCS, HCC/Medicare Risk Adjustment codes, and ensure supportive clinician documentation is present to meet regulatory guidelines and internal controls of KP<BR>- Collate audit results; analyze findings, patterns, trends and variations in coding and documentation practices. Prepare written audit reports with findings and recommendations for improvement. Conduct quality reviews of work medical coding staff to ensure compliance with departmental/internal policies and other applicable laws and regulations<BR>- Utilize query process when code assignments are not straightforward or documentation for coding purposes<BR>- Perform in partnership with the Coding Departments, participate with peers in coding in-services, staff meetings, report performance measures, and quality outcome<BR>- Provide education and/or training when patterns of errors are identified, changes in coding or coding policy occur<BR>- When needed to verify code accuracy fully utilizes resources available such as 3M encoder product, internet medical sites, Coding Clinic or CPT Assistant to research issues that help to apply coding guidelines appropriately and thus ensure accurate code assignment<BR>- Verify code accuracy fully utilizes resources available such as 3M encoder product, internet medical sites, Coding Clinic or CPT Assistant to research issues that help to apply coding guidelines appropriately and thus ensure accurate code assignment<BR>- Review bulletins, newsletters and periodicals, attend workshops to stay abreast of current issues, trends, and changes in the laws and regulations governing medical record coding. Mitigate documentation that may risk fraud and abuse to optimize revenue recovery<BR>- Contribute development and ma                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         </font></td>
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