Facility Inpatient Surgical and Claims Edit Auditor
Cedars-Sinai · Los Angeles, California
What the posting says
Each fact was read from this posting and checked:Statedin the posting, quotedConflictsposted two ways, both shownNot mentionedwe looked; it is not there
- Employment typeStated
- Full time
- Work arrangementStated
- Remote OK
- ExperienceStated
- 2-5 years
- EducationStated
- ['high school', 'professional certificate']
Not mentioned in this posting
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- PayNot mentioned
- The posting does not say
- ShiftNot mentioned
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- Visa sponsorshipNot mentioned
- The posting does not say
Requirements, each with its sentence from the posting
These are the employer’s words. The index does not judge whether you meet them.
- High school diploma or GEDrequired
High school diploma or GED required.
from the posting - Coding audit experiencerequired
A minimum of 3 years of Coding Audit experience with auditing skills covering coding/billing accuracy of coding staff required.
from the posting - CCS, CPC, RHIA or RHIT certificationrequired
CCS, CPC, RHIA or RHIT required upon hire.
from the posting - Health Information Management degreepreferred
Degree in Health Information Management preferred.
from the posting - Facility inpatient surgical claims experiencepreferred
Facility inpatient surgical claims experience highly preferred.
from the posting
Read the full posting as the employer wrote it
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 outstanding levels of employee engagement. We provide an outstanding benefit package that includes health care, 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 I be doing in this role?
The Coding Auditor works under the general direction of the Coding Supervisor. A Coding Auditor is responsible for reviewing encounters in either a prebill or retrospective workflow to validate a coding profile. This includes applicable code sets to encounter type, abstracted data elements, missed query opportunities, and other related encounter data collection points. Auditors evaluate compliance with all coding guidelines including but not limited to: Internal Coding policies/procedures/handbook, American Hospital Association (AHA) and American Medical Association (AMA) coding references, local, State, and Federal Coding Guidelines. Duties include:
- Performs quality coding reviews or audits within established departmental productivity and accuracy standards. Assists with processing re-bills post coding audit changes and assists with coding corrections needed from billing department.
- Provides written summary reports of findings.
- Coordinates and leads 1:1 or small group feedback sessions based on recommendations
- Maintains appropriate open communication with internal and external partners and peer departments such as Coding Operations, Clinical Documentation Integrity (CDI), Payor Revenue Management (PRM), and Compliance Revenue Integrity (CRI).
- Assist peer departments with production coding of cases during shortage of staff.
- Assist in improved data quality for reporting and research, accurate billing and reimbursement of services rendered which overall improves the quality of care for the patient.
- Provide 1:1 and small group education sessions, facilitate round table discussions, contribute content to the coding newsletter, provide basic level trending or data review for opportunities.
- Evaluate codes through data reports and trended opportunities, audit to validate findings, produce summary reports with recommendations of action plans.
- Perform additional activities (e.g. Data quality reports, etc.) as assigned by the Coding Supervisor.
Qualifications
Requirements:
- High school diploma or GED required. Degree in Health Information Management preferred.
- A minimum of 3 years of Coding Audit experience with auditing skills covering coding/billing accuracy of coding staff required.
- CCS, CPC, RHIA or RHIT required upon hire.
- Facility inpatient surgical claims experience highly preferred.
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.
*Approved Remote States: Arizona, California, Colorado, Florida, Georgia, Minnesota, Nevada, Oregon, Texas*
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The posting text is reproduced as the employer wrote it; the index adds nothing to it.