Job Description What will I be doing in this role?
The Senior Physician Compliance Auditor is responsible for reviewing and auditing claims, medical records, and charges to ensure compliance with applicable documentation, coding, and billing requirements. Works closely with, educates, and trains providers and staff on results, identifies issues and/or risks associated with documentation, coding and billing. Acts as a point of escalation for more complex inquiries and issues. In addition, the Senior Physician Compliance Auditor will also work closely with senior leadership on discovered irregularities, needed action items, and makes recommendations to address areas of opportunity. In this role your duties will include:
Performing physician compliance audits to ensure accurate documentation and coding practices are maintained.?? Identifying areas of risk and/or non-compliance and provides recommendations for action - advances as needed.?? Conducting education and training sessions with individual providers on results, regulatory requirements and provide actionable feedback for improvement. Tracking, recording, and maintaining audit/review activity. Responding to complex billing, coding, and documentation inquires. Providing regular and ad hoc reporting Developing and revising education materials, conducting policy review, and ad hoc trainings. Assisting with risk analysis Assisting in training, onboarding, and mentoring new/less experienced team members. Assisting with audit & compliance related special projects as requested.??
?? Qualifications Requirements: High school diploma or GED required. Bachelor's degree preferred. A minimum of 5 years of experience reviewing chart documentation and coding/auditing physician professional services (preferably in a multi-specialty practice) required. A minimum of 3 years of experience with interpretation and communication of rules, regulation and guidelines at an expert level required. A minimum of 1 year of experience coding charts on an academic medical center required.
?? Req ID : 1604
Working Title : Sr. Physician Coding Compliance Auditor
Department : CSRC PB RCC Audit and Edu
Business Entity : Cedars-Sinai Medical Center
Job Category : Patient Financial Services
Job Specialty : Revenue Integrity
Overtime Status : EXEMPT
Primary Shift : Day
Shift Duration : 8 hour
Base Pay : $38.87 - $60.25 About Cedars-Sinai Medical Center
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 competi ... tive 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. Show more
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