Radiation Oncology Coder Certified

GENERAL SUMMARY

The Radiation Oncology Coder Certified is responsible for successfully and efficiently coding all cases to the highest level of accuracy to ensure maximum reimbursement. The Coder Certified will ensure quality and productivity standards are met. The Coder Certified will ensure accurate coding of documentation to include diagnoses, procedures, and modifiers with adherence to established coding guidelines for both government and third-party payers. They work with the Coding Supervisor to escalate coding issues and prevent untimely claim submission and denials.

REQUIREMENTS

• Reviews chart documentation for accuracy and completeness, identify inconsistencies in chart documentation, and work with appropriate staff and Coding Supervisor to resolve issues.
• Communicates with Claims Resolution Specialists and Business Office staff when necessary to resolve errors and clarify issues.
• Demonstrates and use in-depth knowledge of CPT, HCPCS, modifiers, diagnosis codes, insurance coverage plans, medical terminology, and anatomy and physiology.
• Works collaboratively with providers to obtain complete documentation to support coding.
• Stays accountable to quality and productivity standards, and monitor compliance with policies and procedures.
• Identifies process opportunity trends and recommend ways to improve efficiencies.
• Maintains current knowledge of coding guidelines and relevant state and federal regulations.
• Ensures adherence to third party and governmental regulations relating to coding, documentation, compliance, and reimbursement.
• Participates in special projects, personal development training, and cross training as instructed.
• Informs Coding Supervisor of trends, inconsistencies, discrepancies, or payer changes for immediate resolution.
• Works in conjunction with peers and functional areas of the Coding and Revenue Integrity department for the betterment of completing tasks and the company overall.
• Performs other position related duties as assigned.

CERTIFICATIONS, LICENSURES OR REGISTRY REQUIREMENTS

Radiation Oncology Certified Coder (ROCC) required.

KNOWLEDGE | SKILLS | ABILITIES

• Demonstrates an understanding of business operations and how individual actions contribute to overall performance.
• Excellent customer service, verbal, and written communication skills.
• Knowledge of medical terminology, CPT and ICD coding, and the full revenue cycle process.
• Familiarity with Electronic Health Record (EHR) systems and Microsoft Office applications.
• Understanding of Medicare, Medicaid, managed care, and third-party payer guidelines.
• Knowledge of governmental regulations and healthcare compliance requirements.
• Strong analytical and problem-solving skills with the ability to draw conclusions and make recommendations.
• Able to handle multiple tasks and manage competing deadlines with a high level of accuracy and attention to detail.
• Able to develop reports and create professional presentations.
• Well-organized and able to maintain confidentiality in handling sensitive information.
• Self-motivated with a focus on maintaining productivity and efficiency.
• Able to work independently and collaboratively across teams and departments.
• Able to recognize coding issues and prevent untimely claim submission and denials.

EDUCATION REQUIREMENTS

A High School Diploma or equivalent required.

EXPERIENCE REQUIREMENTS

• At least 3 years experience in Radiation Oncology Coding.
• Entry level Medical Billing and Coding Terminology preferred.
• Experience in Urology or physician practice environment preferred.

REQUIRED TRAVEL

N/A