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, ensure the timely implementation of coding updates and guidelines, and maintain 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
• Minimum five (10) years of coding experience using ICD-9, (ICD-10), HCPCS, and CPT-4 code sets.
• Minimum two (5) years of experience with electronic medical records (EMR), practice management systems and workflows
Education
• Bachelor's degree in a related field or a minimum of ten years of equivalent professional experience.
License, Certification, Registration
• AAPC or AHIMA coding certification (CCS, CCS-P, CPC) required.
Additional Requirements:
• N/A
TRAVEL & JOB LOCATION:
• Travel as required (approximately 5% of the time)
• Position will be remote with HQ in Oakland, CA.
PHYSICAL REQUIREMENTS: [Select the typical % of time per category below]
• Seeing: Must be able to read reports, research documents and use a computer. 75-100%
• Hearing: Must be able to hear well enough to communicate with managers, co-workers and customers. 75-100%
• Fingering/Grasping/Feeling: Must be able to write, type, use 10-key and phone system. 75-100%
• Sitting: Must be able to sit for extended periods of time. 75-100%
• Standing/Walking/Mobility: Must be able to stand to open files and operate office machines. Requires mobility between departments and to attend meetings. 25-49%
• Lifting/Pulling/Pushing: Must be able to lift and move up to 10lbs. 25-49%
• Climbing/Stooping/Kneeling. 0-24%
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.
Note: The statements herein are intended to describe the general nature and level of work being performed by the employee(s) assigned to the classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties, and skills required of employees so classified.
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:
• Experience with KP HealthConnect, Epic applications, Epic Chronicles and/or similar electronic medical/health record systems.
• Healthcare project management experience preferred.
• Excellent written and oral communication skills, with the ability to explain complex information in a clear, concise, and organized manner.
• Familiarity with industry terminology and source standards for updates and maintenance, including SNOMED, LOINC, ICD-10, CPT, and HCPCS.
• Ability to build strong working relationships with virtual teams across regional and national levels.
• Strong problem-solving skills and the ability to navigate ambiguity.
• Proficiency using MS Office products, including Excel, Word, PowerPoint, and Access.
• Excellent analytical skills.
• Must possess a thorough knowledge of coding conventions, governmental regulations, and third-party billing requirements.
• Demonstrated ability to solve complex problems using independent judgment.
• Working knowledge of EMR vocabularies such as SNOMED, LOINC, Mesh, and HL7 preferred.