Senior Medical Coding Educator - Remote-Eligible & Impactful

The US Oncology Network; Richardson (TX); Vor Ort; USD 90.000 - 120.000; Vollzeit

Zusammenfassung

The US Oncology Network seeks a Senior Medical Coding Educator for our Texas Oncology team in Richardson. This full-time role supports Revenue Cycle and partners with Coding Operations to drive coding accuracy, education, and process improvements.

Ideal candidates hold active coding and auditing credentials, with oncology/cancer care experience and the ability to lead complex reviews end-to-end. Strong analytical and cross-functional collaboration skills are essential.

Qualifikationen

• High school diploma or equivalent required; a four-year degree in HIM or related field preferred.
• Minimum of seven years of relevant experience in professional coding auditing, reimbursement, or revenue cycle.
• Current professional coding certification (CPC, CCS-P, COC, RHIA/RHIT) and auditing credentials required.
• Strong knowledge of CPT, ICD-10-CM, CPT coding guidelines, payer policies and CMS guidance.
• Ability to manage multiple complex reviews independently and meet deadlines.

Aufgaben

• Performs complex reviews and investigations involving coding, documentation, billing, reimbursement, systems, workflows, and related quality concerns.
• Receives and evaluates review requests originating within Coding Operations or from organizational stakeholders requiring coding and operational expertise.
• Establishes the appropriate scope and review methodology based on the reported concern, potential risk, available information, and affected services or processes.
• Reviews medical records, provider documentation, coding, charges, claims, billing activity, system configuration, operational workflows, policies, procedures, and supporting data to determine the facts and circumstances related to each concern.
• Evaluates concerns from all applicable perspectives and does not limit the investigation to the initially reported issue or assumed cause.
• Determines whether the identified issue is related to coding, documentation, billing, reimbursement, payer requirements, system configuration, workflow, process design, training, staff activity, provider activity, or a combination of factors.
• Conducts focused audits, medical record reviews, claim reviews, data validation, coding validation, and other investigative activities necessary to confirm the concern and determine its scope.
• Researches applicable CPT, HCPCS, ICD-10-CM, CMS, Medicare Administrative Contractor, National Correct Coding Initiative, payer, regulatory, and organizational guidance.
• Distinguishes between the reported concern, validated finding, contributing factors, and root cause before communicating conclusions.

Kenntnisse

Auditing

Investigations

Medical coding education

Data analysis

Regulatory compliance

Ausbildung

Bachelor's degree in Health Information Management (HIM) or related field

High school diploma or equivalent

Tools

Power BI

Jobbeschreibung

The US Oncology Network seeks a Senior Medical Coding Educator for our Texas Oncology team in Richardson. This full-time role supports Revenue Cycle and partners with Coding Operations to drive coding accuracy, education, and process improvements.

Ideal candidates hold active coding and auditing credentials, with oncology/cancer care experience and the ability to lead complex reviews end-to-end. Strong analytical and cross-functional collaboration skills are essential.