Position SummarySr. Coding Analyst
Job Profile Summary:
Texas Oncology is searching for a Sr. Coding Analyst. The Sr. Coding Analyst provides coding and billing education as a subject matter expert in specialty specific categories, conducts Evaluation & Management, Revenue Cycle, Coding & Billing Audits and provides conformance, policy & quality assurance scorecards and recommendations on process improvement.
Texas Oncology delivers high-quality, high-touch care to help cancer patients achieve “More breakthroughs. More victories.” ® in their fight against cancer. We are an independent, physician-led practice delivering leading-edge technology and treatment options and conducting innovative research. Founders of the practice pioneered community-based care to enable more cancer patients to receive high-quality care while staying close to the critical support of family and friends.
Texas Oncology has more than 150 sites of service throughout Texas, with more than 350 physicians dedicated to serving our patients. On average, we treat more than 50,000 new cancer patients each year, with documented growth year over year. Texas Oncology pioneered the concept of community-based, outpatient, multidisciplinary cancer centers. We give local communities access to leading-edge technology that was previously only available in larger metropolitan areas. Texas Breast Specialists and Texas Urology Specialists are a part of Texas Oncology. Texas Oncology is an affiliate of The U.S. Oncology Network, which is owned by McKesson Specialty Health, a division of McKesson Corporation.
ESSENTIAL DUTIES AND RESPONSIBILITIES:
Compliance & Quality Programs Support
Under direction of the Revenue Cycle Manager, Quality & Training Programs:
• Educate and provide guidance related to ICD-10-CM, ICD-9-CM, CPT, HCPCS coding systems.
• Provide guidance related to government regulations and commercial payer policies.
• Educate and provide coding and billing guidance on all new or revised coding for drugs, technologies and procedures.
• Prepare material through research of payer guidelines for claims denials and assist other departments with claims appeal responses.
• Ongoing quarterly review of medical record documentation, for coding and documentation compliance.
• Upon request, support network practices with review of medical record documentation, including but not limited to evaluation and management, medical and radiation oncology, genetic counseling, clinical research, surgical and other specialties.
• Provides feedback and education on documentation, coding and billing.
• Provides support and guidance for new In Market Affiliation (IMA) chart reviews.
• Assist payer audit team with responses to payer audits including but not limited to RAC, CERT, ZPIC, SMRC, and commercial payers.
• Participates in the development and implementation of network practice chart audit programs.
• Collaboration with other MSH departments to provide coding and billing guidance and support.
• Project management duties to include: scheduling and coordination with multiple levels of leadership, physicians, clinical and business staff as well as RSS department and other MSH teams.
• Review, research and respond to practice billing and coding questions.
• Conduct, participate and provide support in practice and USON committee calls.
• Lead designated subject matter expert (SME) initiatives.
• Collaborate, coordinate and participate in other projects and duties as needed or requested
Accepts other duties as requested or assigned.
- 4-year degree in related field or equivalent experience desired
- Successful completion of AAPC certified professional coder examination required
- Five years’ experience in coding, medical records and reimbursement
- Current CPC or CCS-P certification required
- One year of instructional educational experience with a CPC-I or like credential preferred
- Must be familiar with government regulations and applicable reimbursement laws and regulations.
- Thorough knowledge of CPT-4 procedural coding methodology with ICD-10, ICD-9 diagnosis and HCPCS coding.
- Specialized Knowledge/Skills:
- Oncology and Surgery coding are desired
- Project management
- Computer proficiency with Microsoft Office Suite, including MS Word, Excel, Access, and PowerPoint
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 employee site during regularly scheduled business hours and
regularly required to sit or stand and talk or hear. Requires full range of body motion, manual and finger
dexterity, and eye-hand coordination. Requires standing and walking for extensive periods of time.
Occasionally lifts and carries items weighing up to 40 lbs.
Requires corrected vision and hearing to normal range.
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.