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
Our compensation philosophy
We offer competitive total compensation that includes pay, benefits, and other recognition programs for our employees. The base pay range shown above takes into account the wide range of factors that are considered in making compensation decisions including knowledge/skills; relevant experience and training; education/certifications/licensure; and other business and organizational factors. This base pay range does not include our comprehensive benefits package and any incentive payments that may be applicable to this role. Pay Transparency Non Discrimination Provision (PDF) (opens in new window)
Diversity and Inclusion at Cedars-Sinai
We are caretakers and innovators committed to the pursuit of equitable healthcare. But health equity is not possible without representation. Our commitment to diversity goes beyond demographics or checking boxes. Our people must reflect the diverse identities, experiences and geographies of the communities and patients we serve – because that’s what our patients, colleagues and communities deserve. Quality Care and Research—For All, By All (opens in new window).
Cedars-Sinai is an Equal Employment Opportunity employer.
Cedars-Sinai does not unlawfully discriminate on the basis of the race, religion, color, national origin, citizenship, ancestry, physical or mental disability, legally protected medical condition (cancer-related or genetic characteristics or any genetic information), marital status, sex, gender, sexual orientation, gender identity, gender expression, pregnancy, age (40 or older), military and/or veteran status or any other basis protected by federal or state law. If you need a reasonable accommodation for any part of the employment process, please contact us by email at Applicant_Accommodation@cshs.org and let us know the nature of your request and your contact information. Requests for accommodation will be considered on a case-by-case basis. Please note that only inquiries concerning a request for reasonable accommodation will be responded to from this email address.
Cedars-Sinai will consider for employment qualified applicants with criminal histories, in accordance with the Los Angeles Fair Chance Initiative for Hiring.
At Cedars-Sinai, we are dedicated to the safety, health and wellbeing of our patients and employees. This includes protecting our patients from communicable diseases, such as influenza (flu) and COVID-19. For this reason, we require that all new employees receive a flu vaccine based on the seasonal availability of flu vaccine (typically during September through April each year) as a condition of employment, and annually thereafter as a condition of continued employment, subject to medical exemption or religious accommodation. For the same reason, you may also be required to receive other vaccines such as COVID-19 as a condition of employment. Cedars-Sinai reserves the right to make modifications to its required list of vaccines as required by law and/or policy. Cedars-Sinai’s AA Policy Statement (PDF) (opens in new window)
