- 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.
- 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.
- 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.
Coding Auditor - LosAngeles, United States - Cedars Sinai Medical Center
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. We provide an outstanding benefit package that includes healthcare, paid time off and a 403(b). Join us Discover why U.S. News & World Report has named us one of America's Best Hospitals.
What will you 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.
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.
Requirements:
Skills/knowledge we're looking for:
Why work here?
Beyond outstanding employee benefits including health and dental insurance, paid vacation, and a 403(b), we take pride in hiring the best, most passionate employees. Our accomplished staff reflects the culturally and ethnically diverse community we serve. They are proof of our dedication to creating a dynamic, inclusive environment that fuels innovation.
Working Title:
Coding Auditor
Department:
HICoding Audit
Business Entity:
Cedars-Sinai Medical Center
Job Category:
Patient Financial Services
Job Specialty:
Revenue Integrity
Position Type:
Full-time
Shift Length:
8 hour shift
Shift Type:
Day
Base Pay:
$42.83 – $68.53
Cedars-Sinai is an Equal Employment Opportunity 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. If you need a reasonable accommodation for any part of the employment process, please contact us by email at and let us know the nature of your request and your contact information. Requests for accommodation will be considered on a case-by-case basis. Please note that only inquiries concerning a request for reasonable accommodation will be responded to from this email address.
Cedars-Sinai will consider for employment qualified applicants with criminal histories, in accordance with the Los Angeles Fair Chance Initiative for Hiring.
At Cedars-Sinai, we are dedicated to the safety, health and wellbeing of our patients and employees. This includes protecting our patients from communicable diseases, such as influenza (flu) and COVID-19. For this reason, we require that all new employees receive a flu vaccine based on the seasonal availability of flu vaccine (typically during September through April each year) as a condition of employment, and annually thereafter as a condition of continued employment, subject to medical exemption or religious accommodation. For the same reason, you may also be required to receive other vaccines such as COVID-19 as a condition of employment. Cedars-Sinai reserves the right to make modifications to its required list of vaccines as required by law and/or policy. Cedars-Sinai's AA Policy Statement (PDF) (opens in new window)
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