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Kaiser
Duluth, Georgia, United States
(on-site)
Posted
3 days ago
Kaiser
Duluth, Georgia, United States
(on-site)
Job Type
Full-Time
Compliance Consultant III, Risk Adjustment Medical Coding
The insights provided are generated by AI and may contain inaccuracies. Please independently verify any critical information before relying on it.
Compliance Consultant III, Risk Adjustment Medical Coding
The insights provided are generated by AI and may contain inaccuracies. Please independently verify any critical information before relying on it.
Description
Job Summary:In addition to the responsibilities listed below, the position is responsible for serving as a compliance subject matter expert related to coding functions within assigned settings of care, maintaining compliance with national coding policies and procedures, assisting with coding questions and related topics, and assisting with auditing assigned lines of business for coding. Additionally, this position is responsible for assisting with the development of audit result reports and supporting compliance and the Principles of Responsibility (KPs code of conduct).
Essential Responsibilities:
- Pursues self-development and effective relationships with others by proactively providing resources, information, advice, and expertise with coworkers and customers; influencing others through technical explanations and examples; providing occasional mentoring to team members; listening and responding to, seeking, and addressing performance feedback; creating plans to capitalize on strengths and develop weaknesses; anticipating and responding to the needs of others; and adapting to and learning from change, difficulties, and feedback.
- Completes work assignments by applying up-to-date expertise in subject area to generate creative solutions; ensuring all procedures and policies are followed; leveraging an understanding of data, and resources to support projects or initiatives; collaborating cross-functionally to solve business problems; identifying and monitoring priorities, deadlines, and expectations; communicating progress and information; identifying, recommending, and implementing ways to address improvement opportunities; and escalating issues or risks as appropriate.
- Conducts company compliance activities under the guidance of more senior employees by providing support to internal and external stakeholders; applying established regulations and standards to compliance efforts; and documenting compliance activities.
- Assists with compliance reporting efforts by monitoring, and compiling compliance data and information to identify potential risks and remedies; researching, analyzing, and summarizing data; and reporting to senior team members on key compliance drivers, liabilities, and performance indicators (for example, adherence to standards, incorporation of new regulations).
- Assists with compliance investigation efforts by collecting and analyzing data; identifying misalignment with desired compliance actions; conducting interviews as appropriate; determining action steps for resolution; and providing input on corrective action plans.
- Provides support on projects by coordinating stakeholder contacts; assisting in the development, analysis, and coordination of project plans for compliance specific deliverables; and coordinating project schedules and resource forecasts.
- Assists with ensuring regulatory compliance by monitoring regulatory changes; acting on regulatory updates; and supporting the implementation of designated changes.
- Assists in the implementation of compliance efforts by identifying compliance requirements; supporting the assessment of current state compliance to identify gaps and corrective actions; supporting the creation or revision of basic compliance standards, policies and procedures, and training; and monitoring ongoing compliance adherence.
- Minimum two (2) years medical coding experience.
- Bachelors degree in Health Care Administration, Clinical, Law, Public Health, Business or related field and Minimum three (3) years experience in health care compliance, health care operations (quality, risk, etc.), audit, finance, regulatory or public policy development, investigations, information security, or insurance/health plan governance or a directly related field. Additional equivalent work experience in a directly related field may be substituted for the degree requirement.
- Certified Professional Coder from American Academy of Professional Coders OR Certified Coding Specialist from American Health Information Management Association
Additional Requirements:
Preferred Qualifications:
- Two (2) years hospital coding experience.
- Two (2) years coding audit experience.
Primary Location: Georgia,Duluth,Georgia MSAA
Additional Locations:
- Oakland
- Pasadena
- Denver
- Portland
- Silver Spring
- San Diego
- Seattle
- Sacramento
Scheduled Weekly Hours: 40
Shift: Day
Workdays: Mon, Tue, Wed, Thu, Fri
Working Hours Start: 08:00 AM
Working Hours End: 05:00 PM
Job Schedule: Full-time
Job Type: Standard Worker Location: Flexible
Employee Status: Regular
Employee Group/Union Affiliation: NUE-PO-01|NUE|Non Union Employee
Job Level: Individual Contributor
Department: Po/Ho Corp - Medicare LOB Admin - 0308
Pay Range: $74800 - $96690 / year Kaiser Permanente is committed to pay equity and transparency. The posted pay range is based on possible base salaries for the role and does not include the value of our total rewards package. Actual pay determined at offer will be based on years of relevant work experience, education, certifications, skills and geographic location along with a review of current employees in similar roles to ensure that pay equity is achieved and maintained across Kaiser Permanente. Travel: No Flexible: Work location is on-site at a KP location, with the flexibility to work from home. Worker location must align with Kaiser Permanente's Authorized States policy. Kaiser 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.
Requisition #: 1390269
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Job ID: 81095951

Kaiser
California
,
United States
Kaiser Permanente's mission is to provide high-quality, affordable health care services and to improve the health of our members and the communities we serve.
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