Job Posting: We take pride in having the best, most passionate employees. Join our team and help us prove that creating a dynamic, inclusive environment that fuels innovation and makes a difference for the patients we care for. As a Senior Manager of Revenue Cycle Compliance you will have the opportunity to collaborate with the Cedars-Sinai Health System Corporate Integrity Program to support the needs of Cedars-Sinai Medical Network where coding, documentation and data quality compliance is needed. An important part of this role requires establishing system wide coding compliance standards and policies related to documentation and charge capture of professional coding and billing practices. You will provide guidance and education to all departments, including Cedars-Sinai Medical Network, Faculty Departments, Enterprise Information Systems, to promote regulatory charge capture, coding and billing compliance. You will also provide guidance to the Managers of PBS Coding and Physician Education to promote documentation and data quality, compliant billing, charging and Revenue Cycle operational practices. This position requires an influential leader who is a dedicated professional with a commitment to excellence. Essential Job Duties include: - Develops and directs a coding, documentation and data quality Professional compliance program for Cedars-Sinai Medical Network. - Assuring the key elements of an effective revenue cycle compliance program are in place and operationalized such as policies, education, risk assessments, profiling, work plan, monitoring, reporting and corrective/remedial action plans. - Establishes system wide coding compliance standards and policies related to documentation and charge capture of professional coding and billing practices. - Analyzes, reports on, and provides recommendations on corrective action plans, disciplinary actions or compliance issues and risk. - Monitors clinical and non-clinical documentation in accordance with Government guidelines to support claims and all applicable regulations including but not limited to: CPT, ICD10 and HCPCs coding and documentation and medical necessity, Physicians at Teaching Hospitals, Billing for Non-Physician Practitioners, Scribes and Locums Tenens. Uses audits and/or other evaluation techniques to monitor compliance and ensure reductions in identified problem areas. - Oversees the development of coding and documentation training materials and programs for employees and providers. - Managers daily activities for staff members, including job interviewing and hiring; preparation of employee performance reviews; determination of raises, promotions, transfers, and terminations in conjunction with the Vice President of Revenue Cycle and Managed Care Operations. #LI-MDN
Qualification Requirements/Preferences: Education Certifications/Licensure Experience Physical Abilities You must have a minimum of 5 years of experience in working in physician billing compliance in a large, preferably academic institution, minimum of 5 years of experience in researching complex coding compliance issues and questions, and ability to develop effective education programs for adult learners is required and must be CPC certified, CCS certification is preferred. You must understand computer systems, preferably EPIC, and computer programs such as Word and Excel and have working knowledge of management of an effective ethics and compliance program, including training, monitoring, conducting and documenting investigations, addressing violations and monitoring corrective actions. You must also have in-depth knowledge of medical terminology, anatomy, physiology, health information computer systems, and documentation requirements for multi-specialty physician practices. Preferred candidates will have a Master's degree, and experience in governmental chart reviews. You would be expected to conduct all work on-site and travel between facilities.
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 comp...etitive 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.