Job Information
Cedars-Sinai Professional Fee Surgical Audit (Lead Coder Specialist) in United States
Job Description
Align yourself with an organization that has a reputation for excellence! Cedars-Sinai was awarded the National Research Corporation’s Consumer Choice Award 19 years in a row for providing the highest-quality medical care in Los Angeles. We also were awarded the Advisory Board Company’s Workplace of the Year. This annual award recognizes hospitals and health systems nationwide that have high levels of employee engagement. We provide an outstanding benefit package that includes healthcare and a 403(b), along with competitive compensation. Join us! Discover why U.S. News & World Report has named us one of America’s Best Hospitals.
What Will I be Doing in this Role?
Under the general direction of the HID Audit Supervisor, the role operates as a Coding Auditor and shall: Monitor coding compliance through prebill and retrospective reviews or audits of ICD and/or CPT codes assigned by coding staff.
Monitor coding compliance by performing focused audits on high-risk areas identified by the Office of Inspector General (OIG) and the Centers of Medicare and Medicaid Services (CMS).
Identify through focused audits operational and regulatory issues related to coding, documentation, and compliance.
Identify and alert to trends found in reviews or data through Summary Reports. Provide education and training for coders and other healthcare professionals in both one on one and group settings.
Follow Federal, State, and CSHS Compliance requirements to assist in improved data quality for reporting, research, and accurate billing and reimbursement of services rendered.
Assist the HID Coding Department with coding of cases during shortage of staff. Perform additional activities (e.g., Data quality reports, etc.) as assigned.
Opportunity to participate in the Coding Career Ladder Program that could include mentorship.
This position may also focus on research and resolution of claim edits identified through the core abstractions system (EPIC) as well as the claim scrubber system (Availity). If assigned, the position will require an elevated level of research capabilities to be able to facilitate appropriate resolution. Expert organizational skills to keep references in order.
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Qualifications
Requirements:
An associate or bachelor’s degree in health information management or completion of courses in ICD-10-CM/PCS and CPT-4 coding from an accredited coding program or comparable level of education with 10 or more years coding experience in the acute care setting required.
Certification in one of the following: Registered Health Information Technician (RHIT), Registered Health Information Associate (RHIA), Certified Professional Coder (CPC). or Certified Coding Specialist (CCS) required.
Minimum of 5 years of experience in at least one of the following: inpatient coding with the coding of various types of cases (e.g., medical and surgical) and outpatient coding with the coding of various types of cases (e.g., Emergency Room, Surgical/Ambulatory Care. Proficiency in ICD-10-CM and CPT-4 coding with excellent working knowledge of the DRG and APC payment methodologies, AHA Coding Clinic and CPT Assistant required.
3 or more years Coding Audit experience with auditing skills covering coding/billing accuracy, claims processing, denial management, and revenue cycle with a strong focus on Hospital outpatient revenue cycle including Hospital based Clinics required.
Skills/knowledge we're looking for:
Proficiency in ICD-10-CM/PCS and CPT-4 coding with excellent working knowledge of the DRG and APC payment methodologies, AHA Coding Clinic and CPT assistant.
Why work here?
Beyond outstanding employee benefits including health and dental insurance, vacation, and a 403(b) we take pride in hiring the best employees. Our accomplished staff reflects the culturally and ethnically diverse community we serve. They are proof of our commitment to creating a dynamic, inclusive environment that fuels innovation.
Req ID : 4904
Working Title : Professional Fee Surgical Audit (Lead Coder Specialist)
Department : CSRC Coding Audit
Business Entity : Cedars-Sinai Medical Center
Job Category : Patient Financial Services
Job Specialty : Revenue Integrity
Overtime Status : NONEXEMPT
Primary Shift : Day
Shift Duration : 8 hour
Base Pay : $44.10 - $70.56
Cedars-Sinai is an EEO employer. Cedars-Sinai does not unlawfully discriminate on the basis of the race, religion, color, national origin, citizenship, ancestry, physical or mental disability, legally protected medical condition (cancer-related or genetic characteristics or any genetic information), marital status, sex, gender, sexual orientation, gender identity, gender expression, pregnancy, age (40 or older), military and/or veteran status or any other basis protected by federal or state law.