Title : Medical Coding Educator

Department : Quality and Compliance

Type : Full Time

Location : Memorial City, Houston, TX

Job Details :

"You can make a difference in the life of an oncology patient and find your career satisfaction by joining our team of healthcare professionals today."

About Oncology Consultants

Oncology Consultants has been a premier adult medical oncology & hematology practice in Houston, TX for over 35 years. Our healthcare team is committed to provide state of the art cancer treatment in a caring environment as we continue to expand our oncology services in the metropolitan region. 

About the Position

Under the direction of the Director of Quality and Compliance, the Medical Coder Educator reviews services provided and compares them to EHR and billing records to determine accuracy. The Medical Coder Educator is responsible for performing quality reviews of outpatient medical records to validate the integrity of ICD9/ICD-10 diagnoses and procedures as well as CPT/CPT II coded procedures. The Medical Coder Educator reviews medical records and other documentation to identify under and over coded services, prepares reports of findings and meets with management to educate on and improve coding practices. The Medical Coder Educator ensures appropriate coding and maintains compliance documentation. The Medical Coder Educator ensures that billing is optimized, and errors are minimized by identifying opportunities through audit and observation. The Medical Coder Educator remains abreast of regulatory and procedure changes which may affect coding compliance and /or reimbursement.

Shift Schedule:

  • Mon - Fri: 8am - 5pm
  • Mon - Fri 9am - 6pm

Benefits:

  • Insurances: Life, medical, dental, short term and long term disability
  • 401K
  • Free parking
  • PTO
  • Holidays 
  • Competitive salary

ESSENTIAL DUTIES AND RESPONSIBILITIES.

  • Determines priorities and methods of completing daily workload to ensure that all responsibilities are carried out in a timely manner.
  • Performs all job functions in a professional and courteous manner. This includes answering all general phone calls timely, conducting educational meetings, and providing excellent customer service to internal and external customers.
  • Reviews and researches billed unlisted procedure codes to determine if a more specific code exists and should be used.
  • Maintains professional and technical knowledge by attending educational workshops; reviewing professional publications; establishing personal networks; participating in professional societies as necessary or required.
  • Effectively communicates with providers and staff to clarify diagnoses, procedure coding and documentation requirements. Must be able to effectively hold educational teaching meetings with providers and staff to improve coding and billing practices.
  • Reviews assigned ICD-10-CM codes, which most accurately describe each documented diagnosis and/ or procedure according to established ICD-10-CM and CPT coding guidelines along with modifier usage and medical terminology.
  • Tracks coding issues and reviews coding inaccuracies to highlight areas of improvement. Reports or resolves escalated issues as necessary. 
  • Performs a comprehensive medical records review to assure the presence of all component parts including patient and record identification signatures, dates where required, and other necessary data in the presence of all reports which appear to be indicated by the nature of the treatment rendered.
  • Monitors, audits and reconciles all documents required for data entry, returns incomplete or questionable documents to generating location or provider.
  • Provides a high level of technical education and serves as a subject matter specialist regarding coding and documentation.
  • Supports and educates team members about coding best practices and procedures to meet compliance and regulatory requirements.
  • Reviews assigned payment denials, underpayments, and payment take backs for appropriateness and guides resolution by resubmission to the insurance carrier, patient billing, or appropriate adjustment.
  • Collaborates with interdepartmental or cross-functional teams for assigned projects and provides departments with coding issues and updates to be shared with providers to ensure timely and accurate claim payment.
  • Utilizes audit results to provide data-driven feedback to providers and management to improve coding accuracy and identify opportunities for improvement and re-training.
  • Complies with organizational policies and procedures.
  • Performs all other duties as assigned by the Director of Quality and Compliance.

EDUCATION and/or EXPERIENCE:

  • Certified Professional Coder (CPC) with billing office experience required.
  • Must demonstrate a clear understanding of medical terminology, Current Procedural Terminology (CPT), and International Classification of Disease (ICD) coding.
  • Outpatient coding experience or equivalent.
  • General computer and electronic medical record systems experience required.
  • Working knowledge of billing for oncology and hematology-specific discipline preferred.

PHYSICAL DEMANDS:

Normal office environment. Requires sitting and standing associated with a normal office environment. Manual dexterity needed for using a calculator and computer keyboard. This description is intended to provide only basic guidelines for meeting job requirements. Responsibilities, skills and working conditions may change as needs evolve. Ability to read and comprehend simple instructions, short correspondence, and memos in English. Ability to write simple correspondence. Occasional overtime may be required. COMMENTS: This description is intended to describe the essential job functions, the general supplemental functions and the essential requirements for the performance of this job. It is not an exhaustive list of all duties,

LANGUAGE SKILLS: Ability to read and comprehend simple instructions, short correspondence, and memos in English. Ability to write simple correspondence. Occasional overtime may be required. 

COMMENTS:  

This description is intended to describe the essential job functions, the general supplemental functions and the essential requirements for the performance of this job. It is not an exhaustive list of all duties, responsibilities and requirements of a person so classified. Other functions may be assigned and management retains the right to add or change the duties at any time.  

Oncology Consultants is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

Medical Center | Memorial City | Sugar Land | Katy | Willowbrook | Southwest Northwest | West Houston

Apply today. Our short application process takes less than 5 minutes with your phone, tablet or computer.

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