设施住院手术及索赔编辑审计员
Facility Inpatient Surgical and Claims Edit Auditor
与以卓越著称的组织携手！Cedars Sinai 连续19年获得国家研究公司（National Research Corporation）的消费者选择奖，表彰我们在洛杉矶提供最高质量的医疗服务。我们还获得了咨询委员会公司（Advisory Board Company）的年度最佳工作场所奖。该年度奖项表彰全国在员工参与度方面表现突出的医院和医疗系统。我们提供优秀的福利包，包括医疗保险、带薪休假和403(B)退休计划。加入我们吧！了解为什么《美国新闻与世界报道》（U.S. News & World Report）将我们评为全美最佳医院之一。
在这个职位中，你将负责什么？
编码审计员在编码主管的总体指导下工作。编码审计员负责在预审或回顾性工作流程中审查病例，以验证编码配置文件。这包括适用于病例类型的代码集、提取的数据元素、遗漏的查询机会以及其他相关的病例数据收集点。审计员评估是否符合所有编码指南，包括但不限于：内部编码政策/程序/手册、美国医院协会（AHA）和美国医学协会（AMA）的编码参考、本地、州和联邦编码指南。职责包括：
- 在既定的部门生产率和准确率标准内执行质量编码审查或审计。协助处理编码审计更改后的重新计费，并协助解决来自计费部门所需的编码更正。
- 提供发现的书面总结报告。
- 根据建议协调并主持一对一或小组反馈会议。
- 与内部和外部合作伙伴及同级部门保持适当的沟通，如编码运营、临床文档完整性（CDI）、付款人收入管理（PRM）和合规收入完整性（CRI）。
- 在人员短缺期间协助同级部门进行病例的生产性编码。
- 协助提高报告和研究的数据质量，确保服务的准确计费和报销，从而整体提升患者的护理质量。
- 提供一对一或小组教育课程，组织圆桌讨论，为编码通讯提供内容，提供基础级别的趋势分析或数据审查以发现机会。
- 通过数据报告和趋势机会评估代码，进行审计以验证发现结果，生成总结报告。
查看英文原文
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.
What will I be doing in this role?
The Coding Auditor works under the general direction of the Coding Supervisor. A Coding Auditor is responsible for reviewing encounters in either a prebill or retrospective workflow to validate a coding profile. This includes applicable code sets to encounter type, abstracted data elements, missed query opportunities, and other related encounter data collection points. Auditors evaluate compliance with all coding guidelines including but not limited to: Internal Coding policies/procedures/handbook, American Hospital Association (AHA) and American Medical Association (AMA) coding references, local, State, and Federal Coding Guidelines. Duties include:
- Performs quality coding reviews or audits within established departmental productivity and accuracy standards. Assists with processing re-bills post coding audit changes and assists with coding corrections needed from billing department.
- Provides written summary reports of findings.
- Coordinates and leads 1:1 or small group feedback sessions based on recommendations
- Maintains appropriate open communication with internal and external partners and peer departments such as Coding Operations, Clinical Documentation Integrity (CDI), Payor Revenue Management (PRM), and Compliance Revenue Integrity (CRI).
- Assist peer departments with production coding of cases during shortage of staff.
- Assist in improved data quality for reporting and research, accurate billing and reimbursement of services rendered which overall improves the quality of care for the patient.
- Provide 1:1 and small group education sessions, facilitate round table discussions, contribute content to the coding newsletter, provide basic level trending or data review for opportunities.
- Evaluate codes through data reports and trended opportunities, audit to validate findings, produce summary reports with recommendations of action plans.
- Perform additional activities (e.g. Data quality reports, etc.) as assigned by the Coding Supervisor.
Originally posted on Himalayas