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 also were awarded the Advisory Board Company's Workplace of the Year. This award recognizes hospitals and health systems nationwide that have outstanding levels of employee engagement. We offer outstanding benefits and competitive compensation.
Join us! Discover why U.S. News & World Report has named us one of America's Best Hospitals
What You Will be doing in this Role:
In this role you will perform medical record audit (retrospective review) and claims audit to ensure services provided are accurately reflected on the itemized statement and all related billing documents: i.e., UB 04.
Daily/weekly website review of the Federal Register, Medicare and Fiscal Intermediary transmittals, bulletins and memorandum.
Identify coding and billing problems as they pertain to reimbursement (i.e., Ambulatory Payment Classification and Diagnosis Related Grouping)
Implement and communicate updated government program regulations, monitor all government related coding and billing practices, including National Coverage Determination, Local Coverage Determination, Out-patient Code Editor and Correct Coding Initiative edit management, payment reconciliation and financial impact analysis.
Serve as liaison to clinical department Directors and Managers, Health Information Management Coding resources, Information technology, Patient Financial Services and Charge Description Master Management.
Work with hospital personnel throughout the Organization to educate on areas including: documentation, supply charging, and claims reimbursement.
Work cooperatively with CHARGE DESCRIPTION MASTER Analyst in identification of process improvement initiatives relating to coding and charging of hospital services.
Proficient in payment review systems, hospital information systems and coding methodologies.
Understand all ancillary department functions for hospital, their information systems, and charging practices.
Understand CENTER FOR MEDICARE SERVICES memorandums and transmittals, medical records, hospital bills and billing practices.
Perform retrospective coding and medical record documentation review against the itemized charges assigned on government accounts.
Review and communicate updated government program regulations, monitor all government related coding and billing practices, including NCD, LCD, OCE and CCI edit management, payment reconciliation and financial impact analysis to CBR Team.
Work with CBR Team to educate on hospital areas including: documentation, supply charging, claims reimbursement to give examples
Review and resolve Claim Edit, Account and Charge Review work queues accurately to ensure timely billing.
Proficient in review and resolution of CBR assigned work queues, including claim editor application.
High School Diploma or GED required. Bachelors degree in Finance, Economics, Business or a related field preferred.
A minimum of 3 years of experience as an analyst (data, financial business or related) required.
Certificate in Coding (CCS, CPC or COC) required upon hire.
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 t...eaching 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.