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Healthcare, Hospitals & Clinics, Medical Research

Coding Services Technology Auditor

Los Angeles, CAOnsiteFull TimePosted 1 month agoVisa sponsorship availableHidden Gem · Himalayas

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Required skills

  • Registered Health Info Admin
  • Registered Health Info Tech
  • coding guidelines
  • prebill
  • retrospective
  • AHA
  • AMA
  • Coding Operations
  • Clinical Documentation Integrity
  • Payor Revenue Management

Nice to have

  • quality coding reviews
  • re-bills
  • coding corrections
  • production coding
  • data quality reports

Role summary

Cedars-Sinai, an award-winning healthcare organization in Los Angeles, is seeking a Coding Auditor. This role involves reviewing medical encounters in prebill or retrospective workflows to validate coding profiles against established guidelines and policies. Responsibilities include performing quality audits, assisting with re-bills and corrections, generating summary reports, coordinating feedback sessions, and educating stakeholders. The auditor will collaborate with departments like Coding Operations, CDI, PRM, and CRI, and may assist with production coding during staff shortages. The goal is to improve data quality, ensure accurate billing and reimbursement, and enhance patient care quality.

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 health care, generous 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 will I be doing in this role? Certified Coding Spec Phys, Certified Coding Specialist, Certified Professional Coder, Registered Health Info Admin or Registered Health Info Tech required upon hire. In this role you work 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 stakeholders 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.

Originally posted on Himalayas

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