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.
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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.
- Working Title: Senior Revenue Cycle Analyst
- Department: Revenue Management
- Business Entity: Corporate Services
- City: Los Angeles
- Job Category: Patient Financial Services
- Job Specialty: Revenue Integrity
- Position Type: Full-time
- Shift Length: 8 hour shift
- Shift Type: Day
Cedars-Sinai is an EEO 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.Apply NowApply Later