Under the general direction of the HID Audit Supervisor, the lead coding specialist shall: Monitor coding compliance through retrospective reviews or audits of ICD and CPT codes assigned by coding personnel. 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. Comply with Federal, State, and CSMC Compliance Manual 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 (e.g. Data quality reports, etc.) as assigned. This particular 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. If assigned, the position will require a high level of research capabilities to be able to facilitate appropriate resolution. Expert organizational skills to keep references in order. Experience in claim edits and/or denials management a plus.
Providing healthcare for more than 100 years, Cedars-Sinai has evolved into one of the most dynamic and highly renowned medical centers in the world. Along with caring for patients, Cedars-Sinai is a hub for biomedical research and a training center for future physicians and other healthcare professionals. This attracts exceptional talent to Cedars-Sinai, including world-renowned physician-scientists who seek a place where they can both conduct research and see patients--the ideal formula for discovery and its translation into cures. Our patients benefit from access to doctors at the top of their fields, and our researchers have an ideal community in which to study the impact of healthcare challenges, and reflect that knowledge in their research. The greater Los Angeles area in which Cedars-Sinai resides possesses unparalleled cultural and ethnic diversity which offers outstanding opportunities for translational and clinical research... and a dynamic environment for medical education.Although community based, Cedars-Sinai is a major teaching hospital affiliated with the David Geffen School of Medicine at the University of California, Los Angeles (UCLA). Cedars-Sinai has highly competitive graduate medical education programs in more than 50 specialty and subspecialty areas, a graduate program in biomedical sciences and translational medicine, a clinical scholars program directed towards junior physicians with aspirations to become clinical scientists, and post graduate training opportunities.There are more than 250 full-time faculty members at Cedars-Sinai. The voluntary medical staff, comprised of more than 2,200 specialty board-certified or board-qualified physicians, represent all of the specialties and subspecialties and collaborate with full-time medical staff in the teaching responsibilities of the graduate medical education programs.