Sr. Cancer Center Specialty Certified Coder (PD, Remote)
About The Position
Codes cancer center encounters and posts charges for outpatient complex cancer center procedures and diagnoses to support reimbursement, research, statistical data gathering, and compliance. Reviews medical record documentation and assigns appropriate ICD-10-CM diagnoses, CPT codes, and modifiers for hospital and professional claims. Reviews and resolves medical necessity edits, including local and national coverage determinations, and processes revenue-cycle errors. Monitors Discharged Not Billed accounts and helps ensure timely, compliant processing of outpatient and inpatient encounters. Queries physicians when coding assignments are not straightforward or documentation is inadequate, ambiguous, or unclear. Maintains current knowledge of coding guidelines and reimbursement reporting requirements, meets quality and productivity standards, and works independently without direct supervision. The role also supports workflow improvements intended to reduce coding and billing errors.
Requirements
- High school education, GED, or equivalent.
- Experience with RadOnc and MedOnc coding.
- Radiation Oncology Certified Coder (ROCC) certification.
- Meet required quality and productivity standards and comply with third-party, state, and federal regulations.
- Work effectively with a high degree of independence and without direct supervision.
Nice To Haves
- Experience in an acute care setting.
- Experience with Varian, Aria, Mosaiq, and Cerner Oncology programs.
Responsibilities
- Develop physician and departmental relationships.
- Create physician and coder education for the cancer center specialty.
- Perform cancer center coding.
- Handle returns for coding review and resolution.
- Review charges and make corrections as needed.
- Review medical records and assign appropriate ICD-10-CM diagnoses, CPT codes, and modifiers for hospital and professional claims.
- Validate and process medical necessity edits, including local and national coverage determinations.
- Monitor Discharged Not Billed accounts and help ensure timely, compliant processing through the hospital and professional revenue cycle.
- Code and post charges for outpatient complex cancer center procedures and diagnoses for reimbursement, research, statistical data gathering, and compliance.
- Query physicians when coding assignments are unclear or medical record documentation is inadequate, ambiguous, or unclear.
- Assist with designing and implementing workflow changes to reduce coding and billing errors.
- Communicate complex concepts in simple terms to non-finance users, including the appropriate use and limits of information provided.
- Maintain current knowledge of coding guidelines and reimbursement reporting requirements.
- Perform other job-related duties as assigned.
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What This Job Offers
Job Type
Full-time
Career Level
Senior
Education Level
High school or GED
