Physician Coding & Compliance Auditor — Audit & Education

Cedars-Sinai Medical Center; United States; Remote; USD 90,000 - 120,000; Full time

Benefits offered by this job

paid vacation

wellness initiatives

403(b)

Job summary

Cedars-Sinai Medical Center is seeking a Physician Compliance Auditor to review and audit claims, medical records, and charges for compliance with documentation, coding, and billing requirements. This role collaborates with providers and staff to educate and train, and to provide audit results feedback through remote platforms as needed.

The auditor identifies risks, maintains expert knowledge of coding and documentation guidelines, and prepares reports for leadership.

Responsibilities

• Performs physician compliance audits and group audits by analyzing medical record documentation and coding services to ensure compliance with government and organizational policies and procedures.
• Identifies areas of risk and/or non-compliance and provides recommendations for action - advances as needed.
• Conducts education and training sessions with individual providers on audit findings, regulatory requirements and provide actionable feedback for improvement.
• Responsible for summarizing audit results and presenting to provider, operations leaders, and other leadership.
• Communicates feedback directly to providers.
• Prepares necessary reports and communicates audit results to management and clinicians.
• Prepares training and education materials acting as subject matter expert.
• Tracks, records, and maintains audit/review activity in software or excel spreadsheets.
• Provides regular and ad hoc reporting.
• Assists with audit & compliance related special projects as requested.
• Maintains a high level of competency related to medical record documentation, coding and compliance with government regulations by attending appropriate workshops and seminars.
• Monitors Medicare and regulatory agencies rules for updates and changes and supports Cedar-Sinai's core values and procedures.
• Acts as a professional liaison for physician compliance related activities, in a professional and confidential manner.

Job description

Cedars-Sinai Medical Center is seeking a Physician Compliance Auditor to review and audit claims, medical records, and charges for compliance with documentation, coding, and billing requirements. This role collaborates with providers and staff to educate and train, and to provide audit results feedback through remote platforms as needed.

The auditor identifies risks, maintains expert knowledge of coding and documentation guidelines, and prepares reports for leadership.