QA Coding Specialist
OneOncology
- Nashville, Tennessee, United States
- Nashville, Tennessee, United States
Über
Responsibilities
Conduct quality reviews of onshore and offshore billers and coders, to ensure accuracy and compliance with federal, state, and payer-specific regulations, while following industry standards and best practices.
Conduct targeted quality reviews in alignment with the annual OIG Strategic Plan and provide detailed reports of audit outcomes to RCM Leadership and Compliance.
May be required to conduct focused and random quality reviews in response to issues identified by industry trends and standards.
Conduct pre-bill, performance improvement, and established coder quality reviews and provide education and training as necessary for coders to meet 95% accuracy rate.
Analyze data, prepare reports and dashboards, and present review findings to OneOncology RCM leadership and partner practices, including physicians.
Develop educational materials and provide training to staff based on quality review outcomes under the direction of the RCM Quality Review Manager.
Effectively apply and disseminate current billing and coding regulations, auditing, and professional standards.
Collaborate and partner with leadership, compliance, and risk management teams to ensure compliance with all federal, state and local regulations.
Effectively abstract code procedural services for multiple specialties including imaging, medical oncology, pathology and E/M.
Other duties as assigned to help drive our mission of improving the lives of everyone living with cancer.
Qualifications
CPC or other coding certification required
CPMA certification preferred
3+ years of medical auditing experience required
E/M coding experience required
Oncology coding experience preferred
Strong communication and interpersonal skills
Proficiency with Microsoft Office products
Ability to work independently and collaboratively in a team environment
Ability to meet deadlines
Demonstrated success in using data to make decisions and drive behavior change to support organizations
#LI-REMOTE #INDOneOnc
Sprachkenntnisse
- English
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