Sr. RCM Coding Audit Specialist

Job Description

The Sr. RCM Coding Audit Specialist is responsible for providing general coding expertise, including radiation oncology coding, and advice to OneOncology partner practices including physicians as well as to internal team members. This role supports practices in coding and education.

Responsibilities

• Perform physician audits, including specialty-focused audits, compile dashboard results, and provide documentation feedback with coding and billing education to providers.
• Advise practices and the RCM team on best practice coding and provide coding support to practices as needed with hands-on coding and billing, in addition to coding education and training.
• Analyze data, identify issues, reach conclusions, and propose strategies for resolution of complex coding issues, along with leadership.
• Research billing and coding guidelines for any OneOncology practice specialties and advise of coding and guideline updates and changes.
• Apply and disseminate current billing and coding regulations, auditing, and professional standards.
• Identify process improvement opportunities that enhance the performance of the department and/or practice.
• Partner with the leadership team to ensure compliance with all federal, state and local regulations.
• Review medical documentation for accuracy related to payer medical record requests as needed.
• Effectively abstract and code multi-specialty services including radiation oncology services among other sub-specialties such as imaging, medical oncology, pathology and E/M.

Qualifications

• CPC or other coding certification required
• Bachelor’s Degree or equivalent experience required
• 2+ years of coding experience required
• Medical Oncology and Radiation Oncology coding experience preferred
• Demonstrated success in using data to make decisions and drive behavior change in support organizations