Inpatient Coding Auditor

Cedars-Sinai Medical Center; Remote; USD 80,000 - 100,000; Full time

Job summary

A leading medical institution in Los Angeles is seeking a Coding Auditor to ensure compliance in coding practices through audits and education. The ideal candidate has a degree in health information management and certifications such as RHIT or CPC. Responsibilities include monitoring coding compliance, providing training for coders, and assisting with coding during staff shortages. Join a diverse team that values excellence and innovation in healthcare.

Benefits

Health and dental insurance

Paid vacation

403(b) retirement plan

Qualifications

• 10+ years of coding experience in an acute care setting required.
• Minimum of 5 years of inpatient coding experience.
• Proficient in ICD-10-CM/PCS and CPT-4 coding.

Responsibilities

• Monitor coding compliance through audits of ICD and/or CPT codes.
• Provide education and training for coders and healthcare professionals.
• Conduct audits on high-risk coding areas as needed.

Skills

ICD-10-CM coding

CPT-4 coding

Coding audit experience

Revenue cycle management

Denial management

Organizational skills

Education

Associate or Bachelor's degree in health information management

Certification in RHIT, RHIA, CPC, or CCS

Job 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 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 (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.

Qualifications

Requirements:

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 inpatient coding with the coding of various types of cases. 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 inpatient revenue cycle 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 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.

Job Info

• Job Identification 14862
• Legal Employer Cedars-Sinai Medical Center
• Department CSMC 8700002 CSRC Coding Audit
• Job Category Patient Financial Services
• Job Function Revenue Integrity
• Locations 6500 Wilshire Blvd, Los Angeles, CA, 90048, US (Remote)