PB Surgical Auditor

Socket.dev; Los Angeles (CA); On-site; USD 80,000 - 110,000; Full time

Benefits offered by this job

Healthcare

Paid time off

403(b)

Job summary

Cedars-Sinai is seeking a Coding Auditor to review encounters for coding accuracy, ensure compliance with coding guidelines, and support billing processes in a hospital setting.

The role involves producing audit summaries, leading feedback sessions, and collaborating with Coding Operations, CDI, PRM, and CRI to improve data quality and reimbursement outcomes.

Qualifications

• 3+ years of Coding Audit experience required.
• Proficiency with coding guidelines (AHA/AMA) and billing processes.
• Certifications in coding (CCS, CPC) required upon hire or equivalent.

Responsibilities

• Review encounters in prebill or retrospective workflow for coding accuracy.
• Provide written summary reports of audit findings and recommendations.
• Lead 1:1 or small group feedback sessions with staff.

Skills

Coding audits

Data reporting

Team communication

Education

High School Diploma/GED

Degree in Health Information Management preferred

Certified Coding Specialist / Professional Coder / RHIA / RHIT

Tools

None

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 were also awarded the Advisory Board Company’s Workplace of the Year! We offer an outstanding benefits package, including 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 you will be doing in this role:

The Coding Auditor works under the general direction of the Coding Supervisor. The 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.

• 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.
• Performs additional activities (e.g. Data quality reports, etc.) as assigned by the Coding Supervisor.

Qualifications

Requirements

• High School Diploma/GED required with an associate degree/college diploma or bachelor's in health information management preferred.
• A minimum of 3 years' Coding Audit experience with auditing skills covering coding/billing accuracy of coding staff required.
• Certified Coding Spec Phys, Certified Coding Specialist, Certified Professional Coder, Registered Health Info Admin or Registered Health Info Tech required upon hire.

Why work here?

Beyond outstanding employee benefits including health and dental insurance, vacation, and a 403(b) we take pride in hiring the best employees. Our accomplished staff reflects the culturally and ethnically diverse community we serve. They are proof of our commitment to creating a dynamic, inclusive environment that fuels innovation.