Senior Coding Auditor and Trainer

The US Oncology Network is looking for a Senior Medical Coding Auditor to join our team at Texas Oncology! This full time remote position will support our Central Business Office location. We are looking for someone who can work full-time Monday-Friday 40 hours per week.

Notes from the hiring manager:Join our dynamic team in a role that is both challenging and highly rewarding. With exceptional team support, you will have the opportunity to learn and grow every day. Your work will involve assisting coders and supporting clinics and providers, making a significant impact in the healthcare industry.

As a part of The US Oncology Network, Texas Oncology delivers high-quality, evidence-based care to patients close to home. Texas Oncology is the largest community oncology provider in the country and has approximately 530 providers in 280+ sites across Texas, our founders pioneered community-based cancer care because they believed in making the best available cancer care accessible to all communities, allowing people to fight cancer at home with the critical support of family and friends nearby. Our mission is still the same today-at Texas Oncology, we use leading-edge technology and research to deliver high-quality, evidence-based cancer care to help our patients achieve "More breakthroughs. More victories." in their fight against cancer. Today, Texas Oncology treats half of all Texans diagnosed with cancer on an annual basis.

The US Oncology Network is one of the nation's largest networks of community-based oncology physicians dedicated to advancing cancer care in America. The US Oncology Network is supported by McKesson Corporation focused on empowering a vibrant and sustainable community patient care delivery system to advance the science, technology, and quality of care.

What does the Senior Medical Coding Auditor do? (including but not limited to)

Under minimal supervision, provides network physicians and business office staff with applicable billing/ coding and related reimbursement guidelines, to include federal/state laws and regulatory requirements affecting daily business operations. This information is researched and delivered through regular network publications, electronic and voice communications. Participates in the development and maintenance of reimbursement education materials, reviews data reports for coding compliance and provides and/or coordinates the necessary education. Supports and adheres to the US Oncology Compliance program, to include the Code of Ethics and Business Standards.

The essential duties and responsibilities (including but not limited to)

• Provide coding and billing education as a subject matter expert in specialty specific categories.
• Researches, prepares, develops and delivers subject matter material to present to network practice physicians, clinical team and business staff via web based, and other methods of training.
• Educate and provide guidance related to ICD-10-CM, ICD-9-CM, CPT, HCPCS coding systems.
• Provide guidance related to government regulations and commercial payer policies.
• Educate and provide coding and billing guidance on all new or revised coding for drugs, technologies and procedures.
• Prepare material through research of payer guidelines for claims denials and assist other departments with claims appeal responses.
• Ongoing review of medical record documentation, for coding and documentation compliance.
• Upon request, support network practices with review of medical record documentation, including but not limited to evaluation and management, medical and radiation oncology, genetic counseling, clinical research, surgical and other specialties.
• Provides feedback and education on documentation, coding and billing.
• Provides support and guidance for new In Market Affiliation (IMA) chart reviews.
• Assist payer audit team with responses to payer audits including but not limited to RAC, CERT, ZPIC, SMRC, and commercial payers.
• Participates in the development and implementation of network practice chart audit programs.
• Collaboration with other MSH departments to provide coding and billing guidance and support.
• Project management duties to include scheduling and coordination with multiple levels of leadership, physicians, clinical and business staff as well as RSS department and other MSH teams.
• Review, research and respond to practice billing and coding questions.
• Conduct, participate and provide support in practice and USOncology committee calls.
• Lead designated subject matter expert (SME) initiatives.
• Collaborate, coordinate and participate in other projects and duties as needed or requested.

The ideal candidate for the Senior Medical Coding Auditor will have the following background and experience:

• High School diploma or equivalent required.
• Minimum 10 years of billing/coding/medical records experience required.
• Successful completion of AAPC certified professional coder examination required.
• E/M, Infusion, Oncology and Surgery coding preferred.
• Project Management experience preferred.
• Computer proficiency with Microsoft Office Suite, including MS Word, Excel, Access, and PowerPoint.

Physical Demands:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is regularly required to sit and use hands to manipulate a computer keyboard and mouse. The employee is occasionally required to stand, walk, and reach with hands and arms. The employee must occasionally lift and/or move up to 30 pounds. Requires vision and hearing corrected to normal ranges.

Work Environment:

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations maybe made to enable individuals with disabilities to perform the essential functions. Work is performed in an office environment. Involves frequent contact with staff. While performing the duties of this job, the employee is regularly exposed to direct contact with patients with potential for exposure to blood, toxic substances, ionizing radiation and other conditions common to a clinic environment.

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