Cedars-Sinai Lead Coding Auditor in Los Angeles, California
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Beyond an outstanding benefit package and competitive salaries, we take pride in hiring the best, most committed employees. Our staff reflects the culturally and ethnically diverse community we serve. They are proof of our dedication to creating a multifaceted, inclusive environment that fuels innovation and the gold standard of patient care we strive for.
What will you be doing:
The Lead Coding Specialist will Supervise coding compliance through retrospective reviews or audits of ICD and/or CPT codes assigned by coding personnel. Perform 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.
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. If assigned, the position will require a high standard of research capabilities to be able to facilitate appropriate resolution.
Performs quality coding reviews or audits per ICD-10-CM Coding Guidelines and coding guidelines published in AHA in Coding Clinic.
Meets established departmental efficiency and accuracy standards. Performs coding queries when vital for diagnosis and documentation clarification.
Assists with processing re-bills post coding audit changes and assists with coding corrections needed from PFS.
Maintains appropriate communication with supervisor and coding manager regarding audit findings and other significant issues or patterns observed.
Five (5) + years’ experience with Inpatient coding (e.g. medical and surgical) and Outpatient (Ambulatory) coding in the coding of different types (e.g. Emergency Room, Surgical/Ambulatory Care).
Proficiency in ICD-10-CM and CPT4 coding with solid understanding of the DRG and APC payment methodologies, AHA Coding Clinic and CPT assistant.
Three (3) + years’ experience in Coding Audit experience with auditing skills covering coding/billing accuracy of coding staff.
High School Diploma/GED required.
Associate and/or Bachelor’s Degree in Health Information Science, Completion of courses in ICD-10-CM or CPT-4 coding from an accredited coding program, or Comparable level of education with 10+ years coding experience in the inpatient setting.
Certified Coding Specialist (CCS) or Registered Health Information Technician (RHIT) required.
Certified Coding Specialist (CCS-P), Certified Procedural Coder (CPC), Certified Outpatient Coder (COC), and/or Registered Health Information Administrator (RHIA). (preferred)
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.