HIMS Learning Consultant Rockville MD Rockville, MD
( 5 Positions)
To provide professional services training, consultation, and feedback to Health Plan Providers on their clinical documentation and coding and to the internal coding department staff to ensure the KPMAS receives appropriate reimbursement and conforms to applicable guidelines and regulation. This position is expected to be a Coding Subject Matter Expert in at least one of the following Specialties: Internal Medicine, Family Medicine, or Pediatrics.
- Identifies, assesses and develops training interventions. Delivers training programs and assesses l earning transfer. Provides continuous process impr ovement measures to ensure effective training to ind ividua ls and teams. Provides training to assigned client groups. Assists in implementing strategies to track and communicate training status updates. May l ead or partner in the development of training related quality assurance programs. Ensures t hat training information provided to department or functional unit staff members is accurate. Consistent and delivered within prescribed protocols. Provides review, release of charges or coding of any professional services within Epic/KP Health Connect work queue's assigning CPT's, ICD9/10 codes, HCPCS, and/or Modifiers, as needed, providing feedback to providers and HIMS coding community. Maintains awareness of directives of government agencies and legislation as they relate to coding activities. Participates with yearly updates for changes in CPT, ICD9/ICD10 codes, updating systems and paper encounter forms. Participa t es in t he development and implementation of training programs. Provides updates to more senior staff to identify areas that need atten ti on. Develops targeted training programs. D ir ects development of course evaluations. Develops and administers training needs assessments. Analyzes organizational cha ll enges; and deve l ops organ iz ational solut i ons that have a measurable impact on addressing performance gaps and issues.
- May deliver training for cross-functional teams in a continuous learning environment. Helps to assess the accuracy, comprehension and effectiveness of training sessions to ensure alignment with organizational/local goals and initiatives and provides input for process improvements. Delivers train-the-trainer programs to clinical leads, supervisors and HIMS leadership
- Collaborates with compliance, patient financial services, internal audit and other revenue cycle departments on revenue management initiatives. Analyze billing, coding, and denial data to identify root causes and execute on work plans and education to correct identified deficiencies. Analyzes changes to coding rules and regulations by utilizing appropriate reference materials, internet sources, seminars, and publications. Execute on work plans to adapt systems and processes to accommodate changes. Audit accuracy and consistency of coded data by conducting on internal coding audits, studies from medical records and computerized databases. Provide auditing/coding feedback that is incorporated into training and education programs for providers, HIMS coders on existing and future coding, reimbursement, and risk-adjusted severity of illness.
- Collaborates with the KP HealthConnect team to develop and implement strategies to make appropriate
documentation and coding easier for clinicians.
- Provide KPHC onboarding training to provider and HIMS coders new hires.
- Perform other duties as required.
- May act as back-up for auditing if needed.
- Minimum three (3) years of experience delivering training programs.
- Minimum five (5) years of medical coding experience.
- Minimum three (3) years instructional design and delivery.
- Minimum of one (1) year coding audit and quality performance.
- Bachelor's degree in education, Psychology or other related field OR, seven (7) years of experience in a directly related field required.
- High school diploma or GED required.
License, Certification, Registration
- One of the following :
- Registered Health Information Administrator (RHIA),
- Registered Health Information Technician (RHIT),
- Certified Coding Specialist (CCS),
- Certified Professional Coder (CPC), Certified Coding Specialist Physician (CCS-P)
- Certified Outpatient Coder (COC)
- Experience in training needs analysis
- Outstanding written and oral communication and presentation/training skills
- Working knowledge of adult learning techniques and concepts
- Proficient in conflict resolution, group interaction and team building
- Ability to use sound judgment and to handle potentially charged issues independently but with the knowledge and ability to escalate and ask for help when needed
- Ensures regulatory compliance with work product
- Demonstrated ability to interact well with a diverse stakeholder group
- Working knowledge of EPIC or similar electronic medical record system, particularly the clinical and billing modules, encoder(s) (i.e. encoder Pro)
- Microsoft Office suite : Microsoft Project, VISIO
- Articulate and Adobe Captivate
- Master's degree preferred.
Primary Location: Maryland,Rockville,Rockville Regional Offices 2101 E. Jefferson St.
Scheduled Hours (1-40): 40
Working Days: Mon - Fre
Job Type: Standard
Employee Status: Regular
Employee Group: Salaried, Non-Union, Exempt
Job Level: Individual Contributor
Job: Medical Records
Public Department Name: Health Information Management
External hires must pass a background check/drug screen. Qualified applicants with arrest and/or conviction records will be considered for employment in a manner consistent with Federal, state and local laws, including but not limited to the San Francisco Fair Chance Ordinance. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran, or disability status.
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