Coding Education Consultant - NCAL
Company: Kaiser Permanente Zion Medical Center
Location: Redwood City
Posted on: June 6, 2021
Accountable for developing training programs to support accurate
and appropriate coding and documentation. Able to deliver high
quality training independently for multidisciplinary audiences.
Supervises the Data Quality Auditors to ensure planning, scheduling
and performance of concurrent and retrospective encounter audits
are in accordance with regional compliance and Federal and State
requirements. Serves as the local expert on Official Coding and
Documentation Guidelines and other internal and external regulatory
requirements (e.g., Centers for Medicare &Medicaid Service
(CMS), National Committee for Quality Assurance (NCQA).
- Develops training programs that support coding and documentation
improvement and address documentation risk areas identified through
local and regional audits.
- Provides high quality training with minimal support to improve
encounter data capture and coding and documentation accuracy.
- Serves as the expert in supporting the local Coding and
Documentation team to meet local objectives and achieve performance
goals.Participates in various local committees, e.g. CDI, ROG, PCM,
- Supports the local Coding and Documentation team to address
operational processes that hinder encounter data capture.If impact
extends beyond the medical center, work with EIO to assure regional
- Supervises Data Quality Auditors to ensure audits and remediation
are performed accurately and timely, and in accordance with
regional compliance and Federal and State requirements.
- Reviews audit plan, monitors audit schedules, and auditor
accuracy and productivity.
- Assures audit results are entered into regional audit database to
support quality assurance process, regional analysis and regional
- Prepares medical center auditing analysis to determine root
causes of under or over reporting as well as quantifying the effect
of the condition identified in the audit.Recommends appropriate
actions and ensure completion.
- Partners with EIO Training to develop training materials to
address audit trends and risk areas identified based on audit
findings and data analysis.
- Provides expertise to Medical Center leadership and Coding and
Documentation team on internal and external regulatory requirements
(e.g., CMS, NCQA).Works with medical center leadership to provide
confidential audits and feedback on an as needed basis.
- Communicates changes to federal and state government billing and
coding guidelines to medical center leadership, local Coding and
Documentation team, and links the messages between region and the
- Conducts both Medicare and E/M audits on an as-needed
basis.Assures corrective actions are implemented for audit review
- Assists in developing and implementing policies and procedures /
Compliance Audit Standards to ensure compliance with Federal, State
and other regulatory requirements and assures local compliance with
these policies and procedures.
- Mentors and coaches entry level trainers as appropriate.
- Provides project management support for local coding and
- Accountable for consistently demonstrating the knowledge, skills,
abilities, and behaviors necessary to provide superior and
culturally sensitive service to each other, to our members, and to
purchasers, contracted providers and vendors.
- NOTE: Travel between Medical Center facilities may be
- This job description is not all encompassing.
- Minimum seven (7) years of experience in developing programs and
conducting training for diverse audiences with minimal
- Minimum seven (7) years of coding experience based on Coding
Clinic Guidelines for inpatient and outpatient.
- Minimum seven (7) years of experience conducting E/M and Medicare
- Bachelor's degree in business administration, health care, public
health, finance, business medical records technology OR four (4)
years of experience in a directly related field.
- High School Diploma or General Education Development (GED)
License, Certification, Registration
- Certification in one of the following: Registered Health
Information Administrator (RHIA), Registered Health Information
Technician (RHIT), Certified Coding Specialist (CCS), Certified
Professional Coder (CPC).
- Demonstrated ability to
provide coaching and monitoring of daily activities of a complex
- Demonstrated ability to manage processes from initial planning to
successful implementation of plans.
- Demonstrated experience conducting Medical Record audits,
analyzing audit results, creating action plans, and implementing
corrective actions to address audit finding.
- Demonstrated ability to analyze data to identify trends, root
causes, and risk areas, quantify the effects and recommend
- Ability to work with and maintain confidentiality of physicians,
patients, patient accounts and personnel data.
- Strong interpersonal and excellent written, verbal and
- Willingness to be flexible depending upon department and/or
physician schedule needs.
- Must be able to work in a Labor/Management Partnership
- Experience using PC
applications such as MS Word, Excel, Access, PowerPoint.
- Medical center operations or clinical experience.
- Master's degree in business administration, health care, public
health, finance, business medical records technology OR six (6)
years of experience in a directly related field.
Keywords: Kaiser Permanente Zion Medical Center, Redwood City , Coding Education Consultant - NCAL, Other , Redwood City, California
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