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Claims Edit Coder
Job Description
Bring your whole self to exceptional care. Cedars-Sinai was tied for #1 in California in U.S. News & World Report's "Best Hospitals 2024-25" rankings, and it's all thanks to our team of 14,000+ remarkable employees!
What you will be doing in this role:
The Claims Edit Coder (Coder II) operated under the general direction of an audit supervisor and involves responsibilities across various work units, as well as duties specific to the reporting team. In this role, the Coder II reviews ICD-10-CM diagnosis coding and Current Procedural Terminology (CPT) procedure code for claim edit fall outs. The position entails conducting modifier review and assignment, handling complex coding edits that necessitate research and resolution, and validating key data elements like the billing physician and date of service.
You are expected to abstract 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. This role demands proficiency in these systems to ensure the integrity and efficiency of coding operations. Duties include:
- 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.
- 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.
- Expanding skills in procedural coding such as CPT or PCS.
Qualifications
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.
Why work here?
Beyond outstanding employee benefits including health, paid vacation, and a 403(b) we take pride in hiring the best, most passionate employees. Our accomplished staff reflects the culturally and ethnically diverse community we serve. They are proof of our commitment to creating a dynamic, inclusive environment that fuels innovation.
Req ID : 13346
Working Title : Claims Edit Coder
Department : CSRC Coding Audit
Business Entity : Cedars-Sinai Medical Center
Job Category : Patient Financial Services
Job Specialty : Medical Coding
Overtime Status : NONEXEMPT
Primary Shift : Day
Shift Duration : 8 hour
Base Pay : $31.98 - $49.57
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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.
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).
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). 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 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.
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