[Hiring] Lead Surgical Coding Auditor @The US Oncology Network

Role Description

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.

• 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 detail discrepancies and summarize 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.

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.

Requirements

• 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.

Benefits

• 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