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Medical Oncology Auditor

2 months ago

Norfolk, Virginia, United States US Oncology Network-wide Career Opportunities Full time
Job Title: Medical Oncology Auditor-HYBRID

Job Summary:

We are seeking a highly skilled Medical Oncology Auditor to join our team at US Oncology Network. As a Medical Oncology Auditor, you will be responsible for performing complete medical record chart and coding audits for medical and radiation oncology physicians, per The US Oncology Network's established guidelines.

Responsibilities:

  • Perform paper and EMR chart audits for medical oncology physicians/providers in accordance with The US Oncology Network's requirements to ensure medical records are commensurate with captured charges and billing.
  • Use a variety of reports to accomplish tasks, such as AMA guidelines, Medicare LCD's, commercial payor billing guidelines, coding manuals, and ASTRO/ACR guidelines.
  • Prepare a spreadsheet of findings that details discrepancies and summarizes metrics.
  • Identify trends that could be perceived as non-compliance with local and federal regulatory guidelines.
  • Recommend procedural improvements and training opportunities to management.
  • Provide written audit report to supervisor for review and approval.
  • Review approved audit findings with physicians and mid-level providers to discuss recommendations and improvement opportunities.

Qualifications:

  • High School diploma/GED required.
  • CPC required.
  • Nine (9) years of billing, coding, and medical records experience required.
  • Completion of required The US Oncology Network's Reimbursement tutorials as required by the Compliance Department required.
  • Internal Billing and Coding Integrity Program certification (BCS-M) in Medical Oncology and (BCIP) in Radiation Oncology.
  • Must possess a broad knowledge of managed care and HMO policies and procedures and Medicare benefits.
  • Must possess a strong knowledge of current versions of ICD9, CPT4, and HCPCS.

Work Environment:

The work environment may include exposure to communicable diseases, toxic substances, ionizing radiation, medical preparations, and other conditions common to an oncology/hematology clinic environment.

Work will involve in-person interaction with co-workers and management and/or clients. Work may require minimal travel by automobile to office sites.