Director – RCM Coding

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.

Job Description:

The Coding Director is responsible for performance and oversight of the RCM production coding team.   This role is responsible for organizing workload and coding requests, achieving productivity metrics and ensuring goals are met. The Director will be responsible for researching new lines of business and advising the team of pertinent coding and billing changes.  This role will serve as the coding subject matter expert for the One Oncology RCM delivery teams.

Responsibilities

• Manage the coding department, ensuring compliance with coding and billing for the OO production coding team.

• Analyze data, identify issues, reach conclusions, and propose strategies for resolution of complex coding issues, along with leadership. 

• Research billing and coding guidelines for new or current service lines and advise the OO team and partners practices of coding changes.

• Allocate work to the team and ensure tasks are up to date and charge lag metrics are maintained within Company targets.

• Complete all quarterly PEx plans and deliver feedback to the staff including quarterly coaching. 

• Maintain knowledge regarding current billing and coding regulations, auditing, professional standards and effectively apply and disseminate this knowledge.

• Maintain knowledge of HCC coding regulations.  Train practices on HCC workflows as needed.

• Successfully lead and mentor the team, providing coding education and training.

• Identify process improvement opportunities that enhances the performance of the department.

• Ensure the team meets and maintains the company standard for coding performance and quality.

• Provide performance management/corrective action when productivity and quality goals are not met.

• Partner with the management team to ensure compliance with all federal, state and local regulations.

• Effectively code several multiple specialties including medical oncology, radiation oncology, imaging, surgery, and urology.

• Communicate regularly with practices and RCM leaders regarding coding updates, billing education, upcoming coding changes and other key updates.

• Work closely with the Compliance team, sharing information related to coding practices.

• Develop relationship to gain an understanding of audit results which will allow us to better educate practices regarding RCM.

• Other duties as assigned to help drive our mission of improving the lives of everyone living with cancer.

Qualifications

• Excellent matrix management, negotiation, and decision-making skills

• Proven business leader with 5+ years of experience in healthcare and coding

• CPC or other coding certification required

• Oncology and surgical coding experience preferred

• Demonstrated success in using data to make decisions and drive behavior change in support organizations

• Bachelor's degree or equivalent experience required.

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