QA Coding Specialist

About the role

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. This role supports practices in coding and auditing as well as education, ensuring accuracy and compliance with regulations while fostering continuous improvement.

Responsibilities

• Conduct quality reviews of onshore and offshore billers and coders to ensure accuracy and compliance with federal, state, and payer-specific regulations, following industry standards and best practices.
• Conduct targeted quality reviews in alignment with the annual OIG Strategic Plan and provide detailed reports of audit outcomes to RCM Leadership and Compliance.
• Perform focused and random quality reviews in response to issues identified by industry trends and standards.
• Conduct pre-bill, performance improvement, and established coder quality reviews; provide education and training to help coders meet a 95% accuracy rate.
• Analyze data, prepare reports and dashboards, and present review findings to OneOncology RCM leadership and partner practices.
• Develop educational materials and provide training to staff based on quality review outcomes.
• Stay informed regarding current billing and coding regulations, auditing, and professional standards; apply and disseminate this knowledge effectively.
• Collaborate with leadership, compliance, and risk management teams to ensure compliance with all federal, state, and local regulations.
• Effectively abstract and code procedural services for multiple specialties, including imaging, medical oncology, pathology, and E/M.
• Perform other duties as assigned to support the mission of improving the lives of everyone living with cancer.

Qualifications

• CPC or other coding certification required.
• CPMA certification preferred.
• 3+ years of medical coding auditing experience required.
• Medical Oncology and Radiation Oncology coding experience preferred.
• Strong communication and interpersonal skills.
• Proficiency with Microsoft Office products.
• Ability to work independently and collaboratively in a team environment.
• Ability to meet deadlines.
• Demonstrated success in using data to make decisions and drive behavior change to support organizations.