|Skills:||Expert Web-Ex Presenter,Experienced Training of large provider groups,auditing,coding,extensive research of CMS and other Payer guidelines
|Specialties:||Medical Oncology, Injection and Infusion Billing, E&M Key Components, Drug Billing
|Required Certifications:||CPC or CCS-P
|Preferred Certifications:||CPC-I or like credential,Bachelors in Healthcare Administration,or RHIT
|Required Experience:||3 to 4 years
|Preferred Experience:||5 to 7 years
|Location:||10101 Woodloch Forest Drive The Woodlands 77380, TX, US
REMOTE with travel up to 50%
Under minimal supervision, participate in the development and maintenance of reimbursement education materials, review data reports, and prepare review summaries. Prepare educational material through research of payer guidelines for claims denials and assists other departments with claims appeal responses. Upon request, support network practices with review of medical record documentation, including but not limited to evaluation and management, genetic counseling, clinical research, surgical and other specialties. Collaborate with other MSH departments to provide coding and billing guidance and support. Project management duties to include: scheduling and coordination the RSS department and other MSH teams. Coordinate and participate in other projects and duties as needed or requested. Support and adhere to the US Oncology Compliance program, to include the Code of Ethics and Business Standards.
Conduct regular and on-going review of medical record documentation, for coding and documentation compliance. This also entails report generation and preparation to identify trends establishing a robust Coding/Training program.
Review, research and respond to practice billing and coding within a designated timeframe.
Collaboration with Research, Physicians and Central Business Office teams participating in project calls and dashboard creation. Aiding in appeal coordination with Patient Assistance Support.
Collaboration with Managed Care regarding payer contracts.
Collaboration/partnering with Revenue Cycle Management regarding payer related issues.
Researches, prepares, and develops coding material that will be presented to network practice physicians, clinical team and business staff via on-site, web based, and other methods of training.
Development of coding tools/aids.
Research related to government regulations and commercial payer policies.
Prepares and disseminates monthly newsletter. Presentation skills delivering coding changes, monthly and annual webinar.
Minimum Job Qualifications:
Bachelor’s degree in Healthcare Administration or equivalent.
Current CPC or CCS-P certification required.
Instructional educational experience with a CPC-I or like credential preferred. Training large groups.
Required Business Experience:
Five (5) Years Medical Oncology, Evaluation and Management (E&M) and Infusion Therapy coding. Maintaining Compliance and Regulatory Guidelines for network communication. In a physician outpatient environment ONLY.
Must be familiar with government regulations and applicable reimbursement laws and regulations relating to Medical Oncology and Drug reimbursement.
Thorough knowledge of CPT-4 procedural coding methodology with ICD-10 and HCPCS coding.
2 years project management experience.
Proficiency in Microsoft Office (Outlook, Excel, Word, and PowerPoint) required.
General office environment.
Must be available for up to but not limited to 50% travel.
General Office Demands
“Must be authorized to work in the US. Sponsorship is not available for this position.”
Relocation and sponsorship are not available for this position.