Medical Coding Reviewer 1

Mid-Atlantic Permanente Medical Group (MAPMG) invites applications for a Medical Coding Reviewer I to join our Medical Coding team. This position is a Full-Time remote opportunity based out of our regional office located in Washington, D.C.

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 the Director of Retrospective Coding Operations, the Medical Coding Reviewer I will conduct data quality monitoring of physician documentation to validate accurate code assignment in accordance with official coding guidelines, clinical documentation, and regulatory requirements. In this role, you will review medical records, identify potential documentation risks, and apply ICD-10-CM and CPT coding standards to support coding accuracy, quality assurance, analysis, and training activities. 

You can expect to: 

• Review medical records using primary source materials, including CMS and ICD-10 coding guidelines, to determine accurate assignment of diagnoses and procedures.

• Apply ICD-10-CM and CPT codes based on documentation contained within the Electronic Medical Record (EMR).

• Ensure coding practices adhere to established Standards of Ethical Coding.

• Document review determinations in regional databases to support quality assurance, regional analysis, and training activities.

• Identify potential documentation risk areas through medical record reviews.

• Maintain high levels of accuracy and consistency in the selection of diagnosis and procedure codes while meeting established productivity expectations.

• Identify operational processes that may hinder accurate encounter data capture.

• Use Kaiser Permanente HealthConnect (EPIC) to gather and analyze data, interpret findings, and contribute to the development of appropriate action plans.

What is required:

• High School Diploma or General Education Development (GED) with equivalent experience required. Bachelor’s degree in Business Administration, Health Care, Public Health, Finance, Business Medical Records Technology, or a related field preferred.

• Certification in at least one of the following: Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), Certified Coding Specialist (CCS), Certified Professional Coder (CPC), or Certified Risk Adjustment Coder.

• Minimum of one year of experience coding based on Coding Clinical Guidelines.

• Three years of coding experience involving inpatient and outpatient professional services preferred.

• Three years of experience conducting medical record audits preferred.

• Ability to interpret and apply federal and state regulations and coding and billing requirements.

• Ability to maintain the confidentiality of physician, patient, and patient account information.

• Strong interpersonal, written, verbal, and presentation skills.

• Demonstrated ability to work effectively in a team environment and remain flexible based on department and physician scheduling needs

• Must be able to commute to Washington D.C., on an as needed basis.

• Candidates must either currently live in or be willing to relocate to the Washington D.C. metropolitan area

• 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 to $78,390, 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.

MAPMG continuously works to identify and mitigate healthcare inequities and strives to provide an inclusive, supportive environment for physicians and staff. We encourage applicants of any race, color, religion, sex, sexual orientation, gender identity, or national origin who value diversity and are committed to practicing culturally competent healthcare.

External hires must pass a background check and drug screening.