Job Description

OneOncology is positioning community oncologists to drive the future of cancer care through a patient-centric, physician-driven, and technology-powered model to help improve the lives of everyone living with cancer. Our team is bringing together leaders to the market place to help drive OneOncology’s mission and vision.

Why join us? This is an exciting time to join OneOncology. Our values-driven culture reflects our startup enthusiasm supported by industry leaders in oncology, technology, and finance. We are looking for talented and highly-motivated individuals who demonstrate a natural desire to improve and build new processes that support the meaningful work of community oncologists and the patients they serve.

The RCM QA Coding Specialist is responsible for performing quality reviews of onshore and offshore billers and coders, and presenting findings to OneOncology and their partner practices, including physicians. This role is responsible for supporting practices in coding and auditing as well as education.

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

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