Sr. RCM Coding Audit Specialist

 Posted a month ago
     
2-5 years experience
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AI Summary

The specialist provides coding expertise and auditing for radiation oncology and other specialties to partner practices and internal teams. They are responsible for performing physician audits, providing education, and ensuring compliance with federal and state regulations.

OneOncology is positioning community oncologists to drive the future of medical care through a patient-centric, physician-driven, and technology-powered model to help improve the lives of everyone living with cancer and other diseases. Our team is bringing together leaders to the market place to help drive OneOncology’s mission and vision.

Why join us? This is an exciting time to join OneOncology. Our values-driven culture reflects our startup enthusiasm supported by industry leaders in oncology, urology, technology, and finance. We are looking for talented and highly-motivated individuals who demonstrate a natural desire to improve and build new processes that support the meaningful work of independent physicians and the patients they serve.

Job Description:

The Sr. RCM Coding Audit Specialistis responsible for providing general coding expertise, including radiation oncology coding, and advice to OneOncology partners practices including physicians as well as to internal team members.   This role is responsible for supporting practices in coding as well as education.

Responsibilities: 

  • Perform physician audits, including specialty-focused audits, compile dashboard results, and provide documentation feedback with coding and billing education to providers. 

  • Advise practices and the RCM team on best practice coding and provide coding support to practices as needed with hands on coding and billing, in addition to coding education and training. 

  • Analyze data, identify issues, reach conclusions, and propose strategies for resolution of complex coding issues, along with leadership. 

  • Research billing and coding guidelines for any OneOncology practice specialties and advise of coding and guideline updates and changes. 

  • Apply and disseminate current billing and coding regulations, auditing, and professional standards. 

  • Identify process improvement opportunities that enhance the performance of the department and/or practice. 

  • Partner with the leadership team to ensure compliance with all federal, state and local regulations. 

  • Review medical documentation for accuracy related to payer medical record requests as needed. 

  • Effectively abstract  and code multi-specialty services including radiation oncology services among other sub-specialties such as imaging, medical oncology, pathology and E/M. 

  • Other duties as assigned to help drive our mission of improving the lives of everyone living with cancer. 

Qualifications 

  • CPC or other coding certification required 

  • Bachelor’s Degree or equivalent experience required 

  • 2+ years of coding experience required 

  • Medical Oncology and Radiation Oncology coding experience preferred 

  • Demonstrated success in using data to make decisions and drive behavior change in support organizations 

This job description does not contain a full listing of activities, duties or responsibilities required of this role. Duties, responsibilities and activities may change, or new ones may be assigned at any time with or without notice. 

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