OneOncology is focused on supporting community oncologists through a patient-centric, physician-driven, technology-powered model to improve care for patients living with cancer and other diseases.
The RCM QA Coding Specialist performs quality reviews of onshore and offshore billers and coders and presents findings to OneOncology and partner practices. This role supports coding, auditing, education, and compliance initiatives across the revenue cycle.
Key Responsibilities
- Conduct quality reviews of onshore and offshore billers and coders to ensure accuracy and compliance with federal, state, and payer-specific regulations.
- Perform targeted quality reviews aligned with the annual OIG Strategic Plan and report audit outcomes to RCM Leadership and Compliance.
- Conduct focused and random quality reviews in response to industry trends and identified issues.
- Perform pre-bill, performance improvement, and coder quality reviews, and provide education and training to help coders meet a 95% accuracy rate.
- Analyze data, prepare reports and dashboards, and present findings to RCM leadership and partner practices.
- Develop educational materials and provide staff training based on quality review outcomes.
- Stay current on billing and coding regulations, auditing, and professional standards, and apply and share this knowledge appropriately.
- Collaborate with leadership, compliance, and risk management teams to ensure compliance with applicable regulations.
- Abstract and code procedural services across multiple specialties, including imaging, medical oncology, pathology, and E/M.
- Perform other duties as assigned to support the mission of improving the lives of patients living with cancer.
Requirements & Qualifications
Qualifications
- CPC or another coding certification required
- CPMA certification preferred
- 3+ years of medical coding auditing experience required
- Medical Oncology and Radiation 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 using data to make decisions and drive behavior change
Location
Nashville, Tennessee, US
Employment Type
Full-time
Experience Level
Senior
Remote work allowed
Yes
Posted
2 weeks ago