Medical Coding Reviewer I

Mid-Atlantic Permanente Medical Group (MAPMG) invites applications for a Medical Coding Reviewer I to join our Quality department.

This position is a full-time opportunity based out of our regional office with a remote work model.

Mid-Atlantic Permanente Medical Group is comprised of more than 1,700 Permanente physicians and nearly 300 staff professionals who come together to make a positive impact on the health and lives of more than 800,000 members in Virginia, Maryland, and the District of Columbia.

Reporting to a Medical Coding Team Manager , the Medical Coding Reviewer I will conduct data quality monitoring of physician documentation to validate code assignment in compliance with the official coding guidelines as supported by clinical documentation in the health record.

You will support data quality monitoring using official ICD-10 documentation guidelines and regulatory requirements in the Kaiser Permanente Health Connect electronic medical record system.

You can expect to :

• Review medical records using primary sources such as CMS and ICD-10 Coding guidelines to ensure accurate assignment of diagnoses and procedures, and to support these determinations
• Input review determinations into the regional database to support quality assurance, regional analysis, and training activities
• Identify potential documentation risk areas identified through clinical reviews and achieves high levels of accuracy and consistency in selecting diagnosis codes and procedures
• Research plans for data gathering and interpreting data analysis by accessing the KP Health Connect system, and develop action plans based on findings

What is required :

Bachelor's degree in business administration, health care, public health, finance, or medical records technology is preferred;

High School Diploma or General Education Development (GED) required with equivalent experience is required

• Minimum of three (3) years of experience conducting medical record audits and medical coding review
• Minimum of one (1) year of experience coding based on Coding Clinical Guidelines is required
• Certification in one of the following : Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), Certified Coding Specialist (CCS), Certified Professional Coder (CPC) is required
• Certified Risk Adjustment Coder preferred
• Ability to work with and maintain confidentiality of physician and patient encounter data
• Ability to be flexible depending upon department and / or physician schedule needs
• Strong interpersonal and excellent written, verbal, and presentation skills
• Must provide documentation of the Covid vaccine 2-dose series (or J&J 1-dose) prior to October 1, 2023, or documentation for 1-dose of the most current Covid vaccine (Pfizer or Moderna) as a condition of employment
• Must provide documentation for the influenza vaccine as a condition of employment

Competitive Benefits :

• Competitive compensation package
• 100% employer-funded medical and dental insurance premiums for employees and families effective on the first day of employment
• Generous paid time off, including vacation, holidays, and sick leave, plus maternity and parental leave
• Pension plan, and 401(k) retirement plan with employer contributions
• Life insurance, short-term disability, and long-term disability coverage
• Education reimbursement

The starting annual salary for this position ranges from $62,712.22 to $78,390.11 depending on circumstances including an applicant's skills and qualifications, certain degrees and certifications, prior job experience, training, market data, and other relevant factors.

In addition to the salary range above, MAPMG offers rich benefits that add substantial value to the total compensation package.

Equity, Inclusion, and Diversity :

MAPMG continuously works to identify and mitigate healthcare inequities, and that starts with providing an inclusive, supportive environment for our physicians and staff.

We encourage applicants of any race, color, religion, sex, sexual orientation, gender identity, or national origin who value diversity and will commit to practicing culturally competent healthcare.

External hires must pass a background check and drug screening.

We are proud to be an equal opportunity / affirmative action employer.

We value our diversity and E / O / E M / F / D / V.