Senior Medical Coding Educator

Overview

The US Oncology Network is looking for a Senior Medical Coding Educator to join our team at Texas Oncology.  This full-time position will support the Revenue Cycle Departmentat our 3001 E. President George Bush Hwy Suite 100 location in Richardson, Texas.  Typical work week is Monday through Friday 8:00a - 5:00p.

This position will be a Sr level position.

As a part of The US Oncology Network, Texas Oncology delivers high-quality, evidence-based care to patients close to home. Texas Oncology is the largest community oncology provider in the country and has approximately 530 providers in 280+ sites across Texas, our founders pioneered community-based cancer care because they believed in making the best available cancer care accessible to all communities, allowing people to fight cancer at home with the critical support of family and friends nearby. Our mission is still the same today—at Texas Oncology, we use leading-edge technology and research to deliver high-quality, evidence-based cancer care to help our patients achieve “More breakthroughs. More victories.” ^® in their fight against cancer. Today, Texas Oncology treats half of all Texans diagnosed with cancer on an annual basis.

The US Oncology Network is one of the nation’s largest networks of community-based oncology physicians dedicated to advancing cancer care in America. The US Oncology Network is supported by McKesson Corporation focused on empowering a vibrant and sustainable community patient care delivery system to advance the science, technology, and quality of care.

What does the Senior Medical Coding Educator do? (including but not limited to)

Under minimal supervision, provides physicians, advanced practice providers, clinical teams, coding staff, business office staff, and operational leaders with accurate professional fee coding, documentation, billing, and reimbursement education.

This position serves as the primary educational resource for Radiation Oncology and requires advanced Radiation Oncology coding, documentation, billing, and provider education experience. The educator must also possess strong professional fee Evaluation and Management coding and documentation knowledge and be able to support general and multispecialty education needs. Medical Oncology and infusion experience is preferred but does not replace the required Radiation Oncology expertise.

Conducts medical record reviews and develops education based on audit findings, coding trends, payer changes, denials, new or revised codes, documentation concerns, and operational needs. Collaborates with Coding Operations, Audit Operations, Revenue Cycle, reimbursement, clinical leadership, and other organizational stakeholders.

Supports and adheres to the US Oncology Compliance Program, including the Code of Ethics and Business Standards.

Responsibilities

ESSENTIAL DUTIES AND RESPONSIBILITIES:

• Provides coding, documentation, billing, and reimbursement education with primary responsibility for Radiation Oncology and additional support for Evaluation and Management and assigned multispecialty services.
• Researches, prepares, develops, and delivers education to physicians, advanced practice providers, clinical teams, coders, business office staff, and operational leaders through individual sessions, group meetings, webinars, written guidance, and other approved methods.
• Conducts ongoing medical record reviews to identify individual provider, practice, specialty, and organizational education needs.
• Provides timely education related to audit findings, downcoded services, documentation deficiencies, coding errors, medical necessity, modifier use, payer requirements, and identified risk areas.
• Develops Radiation Oncology education covering Evaluation and Management services, treatment planning, simulation, dosimetry, treatment delivery, image guidance, brachytherapy, bundling, modifiers, units, medical necessity, charge capture, and payer requirements.
• Provides professional fee Evaluation and Management education, including code selection, time-based services, medical decision making, split or shared services when applicable, prolonged services, and documentation requirements.
• Supports general and multispecialty education needs based on demonstrated experience, departmental priorities, and assigned responsibilities.
• Researches and applies CPT, HCPCS, ICD-10-CM, CMS, NCCI, LCD/NCD, Medicare Administrative Contractor, government payer, commercial payer, and organizational guidance.
• Reviews, researches, and responds to coding, documentation, billing, and reimbursement questions within established turnaround times.
• Analyzes audit findings, denials, reports, trends, and recurring questions to establish education priorities and identify opportunities for improvement.
• Collaborates with auditors to validate findings, understand contributing factors, and ensure education accurately addresses the identified concern.
• Develops and maintains coding tools, tip sheets, presentations, case studies, provider resources, workflow guidance, and other educational materials.
• Provides education regarding new and revised codes, technologies, procedures, payer policies, regulatory updates, and documentation requirements.
• Supports new provider onboarding, new affiliation reviews, focused education, follow-up education, and competency development.
• Supports payer audit, denial, appeal, and external review activities by researching guidance and providing education as needed.
• Coordinates education schedules, attendance, completion documentation, follow-up activities, and required tracking.
• Validates whether education and corrective actions improved the identified coding or documentation concern and escalates recurring or unresolved issues.
• Maintains complete and accurate documentation of education delivered, supporting references, identified actions, and follow-up status.
• Maintains the confidentiality and security of patient, provider, employee, and business information.
• Meets established quality, productivity, documentation, and turnaround-time expectations.
• Performs other coding education, medical record review, project, regional support, and related duties as assigned.

REQUIRED RADIATION ONCOLOGY EXPERIENCE:

• Minimum of three years of direct professional fee Radiation Oncology coding, documentation, billing, audit, or provider education experience required.
• Prior experience independently educating Radiation Oncology physicians, advanced practice providers, clinical teams, coding staff, or business office staff required.
• Strong knowledge of Radiation Oncology treatment planning, simulation, dosimetry, treatment delivery, image guidance, brachytherapy, bundling, modifiers, units, medical necessity, charge capture, and government and commercial payer requirements required.
• Experience developing Radiation Oncology presentations, written guidance, case-based education, coding tools, and provider-specific feedback required.

GENERAL AND MULTISPECIALTY EXPERIENCE:

• Strong professional fee Evaluation and Management coding, documentation, audit, or education experience required.
• Ability to educate providers and staff on Evaluation and Management code selection and documentation requirements required.
• Experience supporting professional fee coding and education across additional specialties is preferred.
• Medical Oncology and infusion coding, documentation, billing, audit, or provider education experience preferred.
• Surgery, urology, or other professional fee specialty experience is preferred but not required.
• Radiation Oncology experience remains the primary specialty requirement for this position.

Qualifications

MINIMUM QUALIFICATIONS:

High school diploma or equivalent required.

Minimum of five years of professional fee coding, coding education, coding audit, medical records, reimbursement, or related experience required.

Minimum of three years of direct professional fee Radiation Oncology experience required.

Experience independently educating physicians, advanced practice providers, coders, clinical staff, or business office staff required.

Strong professional fee Evaluation and Management coding and documentation knowledge required.

Experience creating presentations, written education, coding tools, case-based education, and provider-specific feedback required.

Strong knowledge of CPT, HCPCS, ICD-10-CM, modifiers, medical necessity, payer billing requirements, and provider documentation requirements required.

Project coordination experience and the ability to manage multiple education requests, deadlines, and stakeholder groups required.

LICENSES AND CERTIFICATIONS:

Current professional coding or auditing certification required. Accepted credentials include:

• Certified Professional Coder (CPC)
• Certified Outpatient Coder (COC)
• Certified Professional Medical Auditor (CPMA)
• Certified Coding Specialist-Physician-based (CCS-P)

A general inpatient-focused CCS credential alone does not satisfy the professional fee coding certification requirement.

Radiation Oncology specialty certification is preferred. Demonstrated Radiation Oncology coding and education expertise is required regardless of certification held.

All required credentials must be active and in good standing at the time of hire and maintained throughout employment.

SPECIALIZED KNOWLEDGE AND SKILLS:

• Exceptional written, verbal, presentation, and interpersonal communication skills.
• Ability to translate complex coding, payer, and regulatory guidance into clear, practical education for technical and nontechnical audiences.
• Ability to provide direct, objective, constructive, and specialty-specific feedback to providers and staff.
• Strong research, analytical, critical-thinking, organizational, follow-up, and problem-solving skills.
• Strong attention to detail and ability to support education with authoritative references.
• Ability to work independently, manage competing priorities, and adjust work based on risk and organizational needs.
• Proficiency with Microsoft Outlook, Word, Excel, Teams, and PowerPoint required. Experience with virtual meeting platforms, electronic health records, practice management systems, Microsoft Lists, Power BI, or other tracking and reporting tools preferred.

PHYSICAL DEMANDS:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. The employee is regularly required to sit or stand, talk or hear, and use hands to handle or operate standard office equipment. The employee must occasionally lift or move items associated with general office work. Specific vision abilities include close vision and the ability to adjust focus.

WORK ENVIRONMENT:

Work is performed in an office, remote, clinical, or classroom environment and requires significant interaction with providers, clinical teams, Coding Operations, Audit Operations, Education, Operations, Revenue Cycle, reimbursement, and other organizational stakeholders. Work involves virtual and in-person interaction. Travel by air or automobile may be required to support assigned regions, practices, and organizational needs.