|Skills:||Coding,Billing,Compliance,Auditing,Clinical Experience in Radiation Oncology
|Required Certifications:||2 Years project managment,medical records and reimbursement experience,3 years coding
|Preferred Certifications:||Radiation Oncology Clinical Experience,ROCC highly preferred
|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 25%
The Radiation / Oncology Senior Clinical Coding Educator will work 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, medical and radiation oncology, genetic counseling, clinical research, surgical and other specialties. Reviews and responds to payer audits including but not limited to RAC, CERT, ZPIC, SMRC, and commercial payers. 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.
1. Conduct regular and on-going review of medical record documentation, for coding and documentation compliance. This also entails report generation and preparation.
2. Review, research and respond to practice billing and coding questions via Ask The Expert (SalesForce) platform within a designated timeframe.
3. Collaboration with Radiation and Imaging team, participate in project calls and dashboard creation.
4. Appeal coordination with Patient Assistance Support.
5. Collaboration with Innovative Practice services to include answering coding questions and attending meetings.
6. Collaboration with Managed Care regarding payer contracts.
7. Collaboration/partnering with Revenue Cycle Management regarding payer related issues.
8. 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.
1. Development of coding tools/aids.
2. Research related to government regulations and commercial payer policies. Prepares and disseminates monthly newsletter.
3. Coding changes/annual webinar.
Minimum Job Qualifications:
Bachelor’s degree in Healthcare Administration or equivalent.
Radiation Oncology Clinical Experience preferred
ROCC certification highly preferred
Required Business Experience:
Three years’ experience in coding, medical records and reimbursement
ROCC certification highly preferred
Must be familiar with government regulations and applicable reimbursement laws and regulations.
Thorough knowledge of CPT-4 procedural coding methodology with ICD-10, ICD-9 diagnosis and HCPCS coding.
2 years project management experience.
Extensive experience in Radiation Oncology coding, medical records and reimbursement requires.
Thorough knowledge of CPT-4 procedural coding methodology with ICD-10, ICD-9 diagnosis and HCPCS coding required.
Experience in coding for Radiation Oncology, Medical Oncology and Surgery.
Proficiency in Microsoft Office (Outlook, Excel, Word, and PowerPoint) required.
General office environment.
Must be available for up to but not limited to 25% travel.
“Must be authorized to work in the US. Sponsorship is not available for this position.”
Relocation and sponsorship are not available for this position.
General Office Demands