Claims Edit Coder

Cedars-Sinai Medical Center•Los Angeles, CA

6d•Onsite

About The Position

Cedars Sinai, an organization recognized for its high-quality medical care and employee engagement, is seeking a Claims Edit Coder (Coder II). This role involves reviewing ICD-10-CM diagnosis coding and CPT procedure coding for claim edit fallouts. The position requires conducting modifier review and assignment, resolving complex coding edits through research, and validating key data elements. The Coder II will abstract coded data accurately and promptly into various systems, including EPIC and Solventum applications.

Requirements

Certified Coding Specialist (CCS), Certified Procedural Coder (CPC), Registered Health Information Technician (RHIT) or Registered Health Information Administrator (RHIA) required upon hire.
High school diploma or GED required.
Minimum of 2 years of experience working doing code assignment in a healthcare setting.
Ability to produce quality work product within the established standards per hour.

Nice To Haves

Proficiency in EPIC (CS-Link), EPIC HB and PB modules, Solventum 360Encompass, Solventum Standalone Encoder, and Select Coder.

Responsibilities

Review medical documentation and health information within various electronic medical or health systems.
Assign applicable codes such as clinical modification (ICD-10-CM), current procedural terminology (CPT), evaluation and management (E&M), and healthcare common procedure coding system (HCPCS) while adhering to productivity and quality standards for the area(s) of assignment or specialty (Facility or Professional).
Focus on specialties including, but not limited to: Professional Multispecialty E&M, Facility Emergency Room (non-Single Path), and Outpatient Visits (Facility or Professional).
Resolve complex edits and alerts with consistent accuracy using current guidelines for the area(s) of assignment or specialty.
Handle edits such as: Simple Visit, Local and National Coverage Determination, and other Related Edits.
Communicate with physicians, providers, and external departments regarding documentation clarity, specificity, and ensure the completeness of documentation required for code assignment within area(s) of assignment or specialty.
Expand skills in procedural coding such as CPT or PCS.