Claims Edit Coder
About The Position
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 annual award recognizes hospitals and health systems nationwide that have outstanding levels of employee engagement. We provide an outstanding benefit package that includes health care, paid time off and a 403(B). Join us! Discover why U.S. News & World Report has named us one of America’s Best Hospitals.
Requirements
- Proficiency in EPIC (CS-Link), EPIC HB and PB modules, Solventum 360Encompass, Solventum Standalone Encoder, and Select Coder.
- Adherence to productivity and quality standards for the area(s) of assignment or specialty (Facility or Professional).
- Consistent accuracy using current guidelines for the area(s) of assignment or specialty.
Nice To Haves
- Experience with ICD-10-CM diagnosis coding.
- Experience with Current Procedural Terminology (CPT) procedure coding.
- Experience with modifier review and assignment.
- Experience with complex coding edits research and resolution.
- Experience validating billing physician and date of service.
- Experience with evaluation and management (E&M) coding.
- Experience with healthcare common procedure coding system (HCPCS) coding.
- Experience with Professional Multispecialty E&M.
- Experience with Facility Emergency Room (non-Single Path).
- Experience with Outpatient Visits (Facility or Professional).
- Experience with edits such as: Simple Visit, Local and National Coverage Determination, and other Related Edits.
- Experience communicating with physicians, providers, and external departments regarding documentation clarity, specificity, and completeness.
- Expanding skills in procedural coding such as CPT or PCS.
Responsibilities
- Reviews ICD-10-CM diagnosis coding and Current Procedural Terminology (CPT) procedure code for claim edit fall outs.
- Conducts modifier review and assignment.
- Handles complex coding edits that necessitate research and resolution.
- Validates key data elements like the billing physician and date of service.
- Abstracts coded data accurately and promptly into the applicable system using relevant applications such as EPIC (CS-Link), EPIC HB and PB modules, Solventum 360Encompass, Solventum Standalone Encoder, and Select Coder.
- Reviews medical documentation and health information within various electronic medical or health systems.
- Assigns 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).
- Focuses on specialties including, but not limited to: Professional Multispecialty E&M, Facility Emergency Room (non-Single Path), and Outpatient Visits (Facility or Professional).
- Resolves complex edits and alerts with consistent accuracy using current guidelines for the area(s) of assignment or specialty.
- Handles edits such as: Simple Visit, Local and National Coverage Determination, and other Related Edits.
- Communicates with physicians, providers, and external departments regarding documentation clarity, specificity, ensure the completeness of documentation required for code assignment within area(s) of assignment or specialty.
- Expands skills in procedural coding such as CPT or PCS.
Benefits
- health care
- paid time off
- 403(B)
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
No Education Listed
