Radiation Oncology Certified Coder

Role Overview

• The Radiation Oncology Coder Certified is responsible for successfully and efficiently coding all cases to the highest level of accuracy to ensure maximum reimbursement.
• Ensure quality and productivity standards are met.
• Ensure accurate coding of documentation to include diagnoses, procedures, and modifiers with adherence to established coding guidelines for both government and third-party payers.
• Work with the Coding Supervisor to escalate coding issues and prevent untimely claim submission and denials.
• Review chart documentation for accuracy and completeness, identify inconsistencies, and work with appropriate staff to resolve issues.
• Communicate with Claims Resolution Specialists and Business Office staff to resolve errors and clarify issues.
• Demonstrate in-depth knowledge of CPT, HCPCS, modifiers, diagnosis codes, insurance coverage plans, medical terminology, and anatomy and physiology.
• Collaborate with providers to obtain complete documentation to support coding.
• Stay accountable to quality and productivity standards and monitor compliance with policies and procedures.
• Identify process opportunity trends and recommend ways to improve efficiencies.
• Maintain current knowledge of coding guidelines and relevant state and federal regulations.
• Ensure adherence to third party and governmental regulations relating to coding, documentation, compliance, and reimbursement.
• Participate in special projects and personal development training as instructed.
• Inform Coding Supervisor of trends, inconsistencies, discrepancies, or payer changes for immediate resolution.
• Collaborate with peers and functional areas of the Coding and Revenue Integrity department for the betterment of tasks and the company overall.

Requirements

• Radiation Oncology Certified Coder (ROCC) required.
• At least 3 years experience in Radiation Oncology Coding.
• Entry level Medical Billing and Coding Terminology preferred.
• Experience in Urology or physician practice environment preferred.
• Knowledge of medical terminology, CPT and ICD coding, and the full revenue cycle process.
• Familiarity with Electronic Health Record (EHR) systems and Microsoft Office applications.
• Understanding of Medicare, Medicaid, managed care, and third-party payer guidelines.
• Knowledge of governmental regulations and healthcare compliance requirements.
• Strong analytical and problem-solving skills with the ability to draw conclusions and make recommendations.
• Ability to handle multiple tasks and manage competing deadlines with a high level of accuracy and attention to detail.
• Capable of developing reports and creating professional presentations.
• Well-organized and able to maintain confidentiality in handling sensitive information.
• Self-motivated with a focus on maintaining productivity and efficiency.
• Ability to work independently and collaboratively across teams and departments.
• Ability to recognize coding issues and prevent untimely claim submission and denials.

Benefits

• Health insurance
• Dental insurance
• Vision insurance
• Life Insurance
• Pet Insurance
• Health savings account
• Paid sick time
• Paid time off
• Paid holidays
• Profit sharing
• Retirement plan