Lead Surgical Coding Auditor/Educator

US Oncology Inc.; Saint Paul (MN); Hybrid; USD 85,000 - 105,000; Full time

Benefits offered by this job

Medical

Dental

Vision

Life Insurance

PTO

Disability Insurance

401k plan

Wellness program

Tuition Reimbursement

Employee Assistance Program

Discount Program

Free Parking

Career Growth

Supportive Team

Job summary

Minnesota Oncology seeks an experienced Medical Billing Auditor and Educator to join our team in Minnesota. You will perform EMR audits, verify documentation against charges, and educate surgeons for accurate reimbursement.

Collaborating with HIM, CDI, and billing teams, you will prepare detailed audit reports, identify trends, and recommend improvements while maintaining patient confidentiality. Remote options may be considered for qualified MN/WI candidates.

Qualifications

• High School diploma or GED; Associate’s or Bachelor's in Health Information Management preferred.
• 7+ years billing, coding, and medical records experience.
• 1+ years auditor/educator experience; CPC certification desirable; knowledge of ICD/CPT/HCPCS; Medicare benefits.

Responsibilities

• Perform EMR chart audits for surgeons to ensure documentation matches charges.
• Train and advise providers on supporting documentation for optimal reimbursement.
• Prepare reports detailing discrepancies and opportunities for improvement.
• Identify coding/documentation trends that may be non-compliant with local guidelines.
• Recommend procedural improvements and training; provide audit reports to supervisor.
• Review audit findings with physicians individually and in groups.
• Collaborate with HIM, CDI, and billing to resolve issues.
• Maintain confidentiality of medical information in records.
• Complete other related duties as assigned.

Skills

Strong math skills

Attention to detail

Excellent oral and written comms

Organizational skills

Follow-up skills

Independent work

Research and apply laws & standards

Education

High School diploma or GED

Associate or Bachelor's in Health Information Management

CPC certification desirable

Tools

ICD knowledge

CPT knowledge

HCPCS knowledge

Job description

Overview

Are you ready to take the next step in your professional journey? At Minnesota Oncology, we believe that our people are our greatest asset, and we are committed to fostering a diverse and inclusive workplace where everyone can thrive. We are constantly on the lookout for talented individuals who are passionate, driven, and eager to make a difference.

Come join this dynamic team who is passionate about providing exceptional care to our patients.

Why Work for Us?

We offer a competitive benefits package that includes -

• Medical
• Dental
• Vision
• Free Life Insurance
• Generous Paid Time Off (PTO) Plan
• Free Short-term and Long-term Disability Coverage
• 401k plan with company contribution
• Wellness program that rewards your healthy lifestyle
• Tuition Reimbursement
• Employee Assistance Program and Discount Program to some of your favorite retailers
• Free Parking
• Career Growth and Development
• Supportive Team and Resources

This position may be remote for well-qualified applicants. Incumbent must be located in Minnesota or Wisconsin.

Responsibilities

SCOPE: Under minimal supervision performs comprehensive audits for all assigned surgeons, including gynecologic, thoracic, and colo-rectal. Verifies critical element documentation and pathway exception documentation in compliance with Federal and State regulations as well as payor guidelines. Provides effective educational feedback to physicians on findings from audits, updates, and provides general training on documentation best practices. 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 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 supporting documentation for optimal reimbursement.
• Prepares reports of findings that details discrepancies and summarizes opportunities for improvement.
• Identifies coding and documentation trends that could be perceived as non-compliant with local guidelines.
• Recommends procedural improvements and training opportunities to management. Provides written audit reports to supervisor for review and approval.
• Reviews approved audit findings with physicians (individually and in a group setting) to discuss recommendations and improvement opportunities.
• Collaborates with Health Information Management (HIM), CDI, and billing teams to resolve documentation and coding issues.
• Maintains the confidentiality of medical information contained in each record.
• Completes other reasonably related duties as assigned.

SALARY RANGE:

$85,000 - $105,000 annually

Qualifications

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.
• 1+ years of auditor/educator experience required.
• Surgical experience strongly preferred.
• 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 required to be present at the employment site during regularly scheduled business hours and 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 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 an office, clinical or classroom environment and requires significant interaction with corporate and network staff. Work will involve in-person interaction with co-workers and management and/or clients. Work may require minimal travel by automobile to other USON buildings.

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.