PB Surgical Auditor

Cedars-Sinai; United States; On-site; USD 65,000 - 90,000; Full time

Benefits offered by this job

Health insurance

Dental insurance

403(b) plan

Paid time off

Job summary

Cedars-Sinai is seeking a Coding Auditor to review encounters and validate coding profiles in prebill or retrospective workflows. You will assess adherence to coding guidelines and ensure data quality for accurate billing and patient care.

Join a team focused on education, collaboration, and continuous improvement within a leading health system. On-site role supporting hospital operations in the Los Angeles area.

Qualifications

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

Responsibilities

• Performs quality coding reviews or audits within established departmental standards.
• Provides written summary reports of findings and coordinates feedback sessions.
• Maintains open communication with Coding Operations, CDI, PRM, and CRI.
• Assists with production coding during staff shortages and with data quality improvement.
• Develops educational content and conducts 1:1 or small group training.

Skills

Coding audit

Healthcare coding

Attention to detail

Communication

Education

Associate degree in HIM

Bachelor's in HIM preferred

Job description

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! Join us! Discover why U.S. News & World Report has named us one of America’s Best Hospitals.

We offer an outstanding benefits package, including healthcare, paid time off and a 403(b).

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.

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.