The Senior Medical Coding Auditor joins the Revenue Cycle Department at Texas Oncology in Richardson, Texas. This role performs comprehensive reviews and investigations involving coding, documentation, billing, reimbursement, systems, workflows, and operational processes.
The position supports coding operations by conducting audits, validating findings, identifying root causes, tracking corrective actions, and communicating outcomes to leadership and other stakeholders. The role works closely with departments such as Coding Operations, Audit Operations, Education, Revenue Cycle, Information Technology, Compliance, and clinical leadership.
This is a senior-level position requiring independent judgment, strong analytical skills, and the ability to manage complex review projects from investigation through closure.
Qualifications
- High school diploma or equivalent required; bachelor’s degree in Health Information Management, Healthcare Administration, Business, Finance, Nursing, or related field preferred
- Minimum of 7 years of relevant experience in professional fee coding, coding audit, billing compliance, reimbursement, healthcare operations, or related revenue cycle functions
- Minimum of 3 years of professional fee coding audit or complex coding review experience
- Experience independently reviewing medical records, determining findings, researching coding or payer guidance, documenting conclusions, and communicating findings to leadership
- Experience with root-cause analysis, issue tracking, written reporting, and cross-functional coordination
- Experience reviewing multiple professional fee specialties; oncology, infusion, surgery, radiation oncology, and E/M experience preferred
- Strong knowledge of CPT, HCPCS, ICD-10-CM, evaluation and management services, modifiers, medical necessity, payer billing requirements, CMS guidance, NCCI edits, LCDs, and NCDs
- Experience with coding and billing systems, EHRs, practice management systems, claim information, data analysis, and operational workflows
- Experience supporting government, regulatory, payer, risk-based, focused, validation, or other complex reviews preferred
Certifications
- Current professional coding certification required: CPC, CCS-P, COC, RHIA, or RHIT
- Current auditing credential required: CPMA, CHA, or equivalent nationally recognized healthcare coding audit credential
- CPC, CCS-P, or COC holders must also have an active auditing credential
- Credentials must be active and maintained throughout employment
Skills
- Strong analytical, investigative, organizational, critical-thinking, written communication, verbal communication, follow-up, and problem-solving skills
- Strong attention to detail
- Ability to work independently and proactively with urgency and tact
- Ability to manage competing priorities
- Proficiency with Microsoft Outlook, Word, Excel, and PowerPoint; Power BI, Microsoft Lists, Access, audit software, EHRs, and claims systems preferred
Location
Texas, US
Employment Type
Full-time
Experience Level
Senior
Remote work allowed
Yes
Posted
3 weeks ago