[Hiring] Facility Inpatient Surgical and Claims Edit Auditor @Cedars-Sinai

Role Description

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

Duties include:

• Performing quality coding reviews or audits within established departmental productivity and accuracy standards.
• Assisting with processing re-bills post coding audit changes and coding corrections needed from the billing department.
• Providing written summary reports of findings.
• Coordinating and leading 1:1 or small group feedback sessions based on recommendations.
• Maintaining 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).
• Assisting peer departments with production coding of cases during shortage of staff.
• Assisting 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.
• Providing 1:1 and small group education sessions, facilitating round table discussions, contributing content to the coding newsletter, and providing basic level trending or data review for opportunities.
• Evaluating codes through data reports and trended opportunities, auditing to validate findings, and producing summary reports with recommendations of action plans.
• Performing additional activities (e.g. Data quality reports, etc.) as assigned by the Coding Supervisor.

Qualifications

• Experience in coding auditing or related field.
• Knowledge of coding guidelines and regulations.
• Strong analytical and communication skills.

Requirements

• Certification in coding (e.g., CPC, CCS).
• Proficiency in coding software and tools.
• Ability to work collaboratively in a team environment.

Benefits

• Health care coverage.
• Paid time off.
• 403(B) retirement plan.