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Professional Fee Surgical Audit (Lead Coder Specialist) - Remote
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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Diversity and Inclusion at Cedars-Sinai
We are caretakers and innovators committed to the pursuit of equitable healthcare. But health equity is not possible without representation. Our commitment to diversity goes beyond demographics or checking boxes. Our people must reflect the diverse identities, experiences and geographies of the communities and patients we serve – because that’s what our patients, colleagues and communities deserve Quality Care and Research—For All, By All.
Our compensation philosophy
We offer competitive total compensation that includes pay, benefits, and other recognition programs for our employees. The base pay range shown above takes into account the wide range of factors that are considered in making compensation decisions, including knowledge/skills; relevant experience and training; education/certifications/licensure; and other business and organizational factors. This base pay range does not include our comprehensive benefits package and any incentive payments that may be applicable to this role. Pay Transparency Non-Discrimination Provision (PDF).
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 Applicant_Accommodation@cshs.org 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). 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 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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