Title: Sr. Medical Oncology Compliance Educator
Hub Locations: Atlanta, GA; Columbus, OH; Dallas, TX; Richmond, VA
Remote/Hybrid/Onsite: REMOTE
Industry Experience: Healthcare Required
Position Description:
Under minimal supervision, the Medical Oncology Educator - provides applicable billing, coding, and related reimbursement guidelines, to include federal/state laws and regulatory requirements affecting daily business operations applicable to Medical Oncology. Upon request, support network practices with education services of medical record documentation, including but not limited to the following services: evaluation and management, genetic counseling, licensed clinical social work, laboratory, care planning and management, revenue cycle and other services common to the Medical Oncology specialty. Upon request provide review and/or audits of including but not limited to the following services: evaluation and management, genetic counseling, licensed clinical social work, laboratory, care planning and management, and other services common to the Medical Oncology specialty. Collaborate with other McKesson Specialty Health departments and US Oncology Network practices to provide coding and billing guidance and support. Project management duties to include scheduling and coordination education with practices, revenue cycle- billing offices, physicians, APPs, and other US Oncology business departments. Coordinate and participate in other projects and duties as needed or requested. Must have exceptional communication skills and be able to speak to and relate to Providers, APPs, and Other Healthcare Professionals. This position requires a close working relationship with clinical, coding, and billing staff. Extensive knowledge of government regulations, applicable reimbursement laws and regulations required. Support and adhere to the US Oncology Compliance program, to include the Code of Ethics and Business Standards.
Key Responsibilities:
- Researches, prepares, and develops coding material that will be presented to network practice physicians, clinical team, and business staff via on-site, web based, and other methods of training.
- Conduct monthly webinars on various healthcare related topics.
- Conduct regular and on-going review of medical record documentation, for coding and documentation compliance. Provide one on one education to physicians, APPs, and other clinical staff related to compliance audits, or third-party reviews.
- Conduct as needed coding and billing reviews for medical record documentation, for coding and documentation compliance. Prepare reports of findings and recommendations for improvement for internal review and distribution to business leaders and Compliance leadership.
- Report generation and analysis to identify trends within The Network
- Assist with establishing a robust Coding/Training program.
- Review, research, and respond to practice billing and coding questions within a designated timeframe.
- Collaboration with Compliance Auditing Team regarding reviews and provide education for improvement.
- Collaboration/partnering with Revenue Cycle Management regarding payer related issues.
- Development of coding tools/aids.
- Research related to government regulations and commercial payer policies.
Minimum Job Qualifications:
- 7+ years of overall professional work experience
- 4+ years of direct experience in CPT, ICD-10-CM, and HCPCS coding for Medical Oncology or Infusion Services.
Education/Training:
- Current CPC required, CPMA and/or CCS-P certification a plus.
- Bachelor’s degree in healthcare administration or health information management
Critical Skills:
- Three (3) Years Compliance Auditing and Physician Education.
- Three (3) Years Medical Oncology, Evaluation and Management (E&M).
- Three (3) Years Infusion Therapy coding.
- Presentation skills delivering coding related information, monthly and annual webinars.
- Must be familiar with compliance and government regulations and applicable reimbursement laws and regulations relating to Medical Oncology and Drug reimbursement. In a physician outpatient environment ONLY.
- Thorough knowledge of CPT, ICD-10-CM and HCPCS coding.
- 2 years project management experience.
- Proficiency in Microsoft Office Products (Outlook, Excel, Word, Teams, and PowerPoint) required.
- Experience using virtual meeting platforms (such as WebEx and Zoom) required.
- Laboratory Billing and regulatory guidance is a plus.
Physical Requirements:
General Office Demands
Travel:
Must be available for up to but not limited to 20% travel.
Must be authorized to work in the US. Sponsorship is not available for this position.
