Medical Coding Auditor

SCOPE:
Under general supervision, performs complete medical record chart and coding audits for medical and radiation oncology physicians and surgeons, as per the USON established guidelines. Supports and adheres to the US Oncology Compliance Program, to include the Code of Ethics and Business Standards.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

• Performs EMR chart audits for medical or radiation oncology physicians/providers and surgeons in accordance with USON requirements to ensure medical records are commensurate with captured charges and billing.
• Works directly with providers to train and advise on optimal supporting documentation for reimbursement.
• Identifies coding and documentation trends that could be perceived as non-compliance with local and federal regulatory guidelines.
• Identifies opportunities for procedural improvements and training. Provides written audit report to supervisor for review and approval.
• Reviews approved audit findings with physicians and providers to discuss recommendations and improvement opportunities.
• Collaborates with Health Information Management (HIM), CDI, and billing teams to resolve documentation and coding issues.
• Maintains detailed records of audits, findings, and corrective actions in accordance with organizational and regulatory requirements
• Maintains the confidentiality of medical information contained in each record.
  Completes other reasonably related duties as assigned.

SALARY RANGE:

$75,000 - $95,000 annually

MINIMUM QUALIFICATIONS:

• High School diploma or GED, Associate's or Bachelor's degree in Health Information Management or related healthcare field preferred.
• 7+ years of billing, coding, and medical records experience.
• CPC certification is highly desired.
• Must possess a broad knowledge of managed care and HMO policies and procedures and Medicare benefits.
• Must possess a strong knowledge of current versions of ICD, CPT and HCPCS.

COMPETENCIES:

• Strong math skills and attention to detail;
• Excellent oral and written communication skills;
• Excellent organizational and follow-up skills;
• Ability to work independently;
• Ability to independently research issues and apply laws & standards.

PHYSICAL DEMANDS:
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is regularly required to sit or stand and talk or hear. The employee frequently is required to use hands to finger, handle, or feel and occasionally required to reach with hands and arms. The employee must frequently lift and/or move up to 10 pounds and occasionally lift and/or move up to 10 pounds. Specific vision abilities required by this job include close vision and ability to adjust focus.

WORK ENVIRONMENT:
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Work is performed in a clinical environment and requires frequent interaction with staff, patients and the public. Work may require minimal travel by automobile to other medical sites.

The US Oncology Network is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, disability or protected veteran status.