What are the responsibilities and job description for the Compliance Consultant II, Medical Coding position at Kaiser Permanente?
The Permanente Federation LLC (the Federation) is the national leadership and consulting organization for the eight Permanente Medical Groups (PMGs), which, together with the Kaiser Foundation Health Plans (KFHP) and Kaiser Foundation Hospitals (KFH), comprise Kaiser Permanente. The PMGs employ nearly 24,000 physicians, approximately 90,000 nurses, other clinicians and staff, and provide care to over 12.6 million Kaiser Permanente members. The Federation works on behalf of the PMGs to optimize care delivery and advance Permanente Medicine – medicine that is patient-centered, evidence-based, technology-enabled, culturally responsive, team-delivered, and physician-led. The Federation, based in Oakland, California, is dedicated to serving and leading Permanente Medicine, the Permanente Medical Groups, and Kaiser Permanente in support of our patients and members.
The people of The Permanente Federation support each other in creating an equitable, diverse, and inclusive culture. We strive to be empathetic in our interactions with each other and learn from our mistakes. We are committed to strengthening our impact by representing the diverse population of patients and physicians we serve while upholding a culture of fairness and acceptance.
SUMMARY :
In this role, the incumbent will be a coding terminology specialist responsible for managing and ensuring the quality of clinical and coding data for the enterprise Masterfile. Responsibilities will include the development and enhancement of clinical systems, ensuring compliance with regulatory standards and internal policies, and fostering a culture of ethics and integrity by supporting coding and billing functions, ensuring the timely implementation of coding updates and guidelines, and maintaining up-to-date knowledge of coding conventions, regulations, and third-party billing requirements.
Essential Responsibilities :
- Ensure compliance with Kaiser Permanente’s Code of Conduct, federal and state laws, accreditation requirements, and internal policies.
- Contribute to the accuracy and usability of diagnosis and procedure code master files and related system tools.
- Participate in root cause analysis of data and workflows, contributing to the design of cross-application solutions.
- Gain expertise in KP HealthConnect (Epic) and Kaiser Permanente's revenue cycle processes.
- Support code validation for government-mandated regulatory updates, SOX compliance, and CMT QA projects for KP HealthConnect clinical Diagnosis and Procedures Master Files.
- Co-chair the Inter-regional Coding Forum, including preparation, facilitation, and documentation.
- Participate in code validation meetings with KP HealthConnect business partners.
Basic Qualifications :
Experience
Education
License, Certification, Registration
TRAVEL & JOB LOCATION :
PHYSICAL REQUIREMENTS :
WORK ENVIRONMENT :
General office environment : Work is generally sedentary in nature, but may require standing and walking for up to 25% of the time. The working environment is generally favorable. Lighting and temperature are adequate, and there are no hazardous or unpleasant conditions caused by noise, dust, etc. Work is generally performed within an office environment, with standard office equipment available.
EEOC STATEMENT :
The Permanente Federation, LLC provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, gender, sexual orientation, gender identity or expression, national origin, age, disability, genetic information, marital status, amnesty, or status as a covered veteran in accordance with applicable federal, state, and local laws. The Permanente Federation, LLC complies with applicable state and local laws governing non-discrimination in employment in every location in which the company has facilities. This policy applies to all terms and conditions of employment, including, but not limited to, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training.
Preferred Qualifications :
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