Coding Auditor

Job Summary: 

Under the general direction of the HID Audit Manager, the lead coding specialist shall: Monitor coding compliance through retrospective reviews or audits of ICD and/or CPT codes assigned by coding personnel. 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. Comply with Federal, State, and CSMC Compliance Manual 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

Educational Requirements:

Associate or Bachelors degree in Health Information Management or completion of courses in ICD-10-CM/PCS and/or 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 License/Certification/Registration Requirements: Certification in one of the following: Registered Health Information Technician (RHIT), Registered Health

Licenses:

Certification in one of the following: Registered Health Information Technician (RHIT), Registered Health Information Associate (RHIA), Certified Professional Coder (CPC). Certified Outpatient Coder (COC), or Certified Coding Specialist category (CCS, CCS-P)

Experience:

Minimum of 5 years of experience in the following: inpatient coding with the coding of various types of cases (e.g. medical and surgical), outpatient coding with the coding of various types of cases (e.g. Emergency Room, Surgical/Ambulatory Care. Proficiency in ICD-10-CM/PCS and/or CPT-4 coding with excellent working knowledge of the DRG and APC payment methodologies, AHA Coding Clinic and CPT assistant. In addition, 3 or more years Coding Audit experience with auditing skills covering coding/billing accuracy , claims processing, denial management, or revenue cycle with a strong focus on Hospital outpatient revenue cycle including Hospital based Clinics.

Physical Demands:

Lifts, carries, moves and pushes equipment, books, paperwork and materials related to assigned work demanding ability to lift up to 30 pounds. Ability to sit for prolonged periods of time, use a computer keyboard for prolonged periods of and look at a computer monitor for extended periods of time

Working Title:

Coding Auditor

Department:

HICoding Audit

Business Entity:

Corporate Services

Job Category:

,Patient Financial Services,Patient Financial Services

Job Specialty:

Revenue Integrity

Position Type:

Full-time

Shift Length:

8 hour shift

Shift Type:

Day

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. If you need a reasonable accommodation for any part of the employment process, please contact us by email at [email protected] 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.

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