HIM Coder II

Health Information Management Coders

HIM Coders are responsible for coding a variety of services including: Ambulatory Surgery, hospital professional visits and procedures, clinic visits and procedures (including Urgent Care), Pathology and EKGs. Both ICD-9 and ICD-10 coding is performed, depending on the date of service. Coders read and interpret medical record documentation to identify codeable diagnoses, services and supplies, and assign codes as appropriate. They follow industry-standard coding and payor guidelines and KFHPW policy and procedures in the application of coding methodologies and medical record interpretation. Coders also are required to have knowledge of the KFHPW billing system to assure the coded data produces a clean claim. Coding is critical for billing and reimbursement of services provided by Kaiser Foundation Health Plan of Washington providers and staff. Coded data is also used in practice management and in managing patient populations. Coding is required to submit compliant bills, and for reporting Medicare encounter data.

Essential Responsibilities:

• Code hospital, ambulatory surgical center and clinic services by assigning ICD-9, ICD-10, CPT and HCPCS codes for facility and/or professional services delivered to patient by Kaiser Foundation Health Plan of Washington providers and staff using encoding software and coding books. Apply knowledge of medical science, medical terminology, anatomy and physiology, and official coding guidelines to select codes. Abstract medical information from electronic or paper medical record systems. Perform data entry via electronic encoder or via manual data entry.
• Maintain KFHPW standards for coding quality and productivity. Maintains required certification by pursuing ongoing coding and health information continuing education. Track and report productivity based on current departmental processes. Track and log other data on coding activities or documentation quality as requested by management.
• Attend staff meetings and trainings as required by management which are held at various Kaiser Foundation Health Plan of Washington locations in the Puget Sound area.
• Support the Kaiser Foundation Health Plan of Washington values of customer focus, accountability, innovation, excellence and integrity by actively participating in and contributing to improvements in team communications, work flow efficiencies, and enhancements to overall coding quality.

Basic Qualifications:

• N/A

Education

• Vocational school/certificate program in medical terminology; medical science and disease processes; anatomy and physiology; ICD, CPT and HCPCS coding, and coding guidelines.

License, Certification, Registration

• Certified Professional Coder - Hospital Outpatient OR Registered Health Information Technician OR Certified Coding Specialist OR Certified Professional Coder OR Registered Health Information Administrator OR Certified Outpatient Coder OR Certified Coding Specialist - Physician Based

Additional Requirements:

• Knowledge of ICD, CPT and E&M coding and HCPCS coding, including application of official coding guidelines for hospital, ambulatory surgery and clinic settings.
• Knowledge of medical billing and compliance requirements.
• Customer service, communication, interpersonal and organizational skills.
• Computer skill in MS Windows environment, including Excel and 10-key.

Preferred Qualifications:

• Working knowledge of electronic medical record systems and encoder applications.
• More than one coding certification at time of hire/transfer.
• Associates degree in health information technology from CAHIM-accredited program.