Subject Matter Expert (SME) - Medical Coder (Oncology)

We are seeking an experienced and knowledgeable Subject Matter Expert (SME) in Medical Coding with a specialization in Oncology. The SME will provide expert guidance and support in oncology medical coding, ensuring accuracy and compliance with coding standards and regulatory requirements. This role involves collaborating with clinical staff, coding teams, and other stakeholders to enhance coding practices and maintain high-quality coding standards.

Key Responsibilities:

1. Expert Coding Guidance:

• Serve as the primary resource for oncology coding inquiries, providing expert advice on coding practices, guidelines, and regulations.
• Review and validate oncology-related medical codes to ensure accuracy and adherence to coding standards.

2. Coding Process Management:

• Develop, implement, and refine coding practices and workflows specific to oncology.
• Monitor coding accuracy and productivity, providing feedback and recommendations for improvement.

3. Compliance and Regulation:

• Ensure all oncology coding activities comply with relevant regulations, including ICD-10, CPT, and HCPCS codes.
• Stay updated with changes in coding regulations and industry best practices, integrating these updates into coding procedures.

4. Training and Development:

• Conduct training sessions and workshops for coding staff on oncology coding practices and updates.
• Create and maintain coding reference materials, guidelines, and documentation.

5. Collaboration and Communication:

• Collaborate with oncologists, clinical staff, and coding teams to address and resolve complex coding issues.
• Communicate effectively with internal and external stakeholders to ensure accurate and efficient coding practices.

6. Quality Assurance and Auditing:

• Perform regular audits of oncology coding activities to ensure accuracy and compliance.
• Address and resolve any discrepancies or issues identified during audits, implementing corrective actions as necessary.

7. Reporting and Analysis:

• Prepare and present reports on coding metrics, trends, and performance related to oncology.
• Analyze coding data to identify areas for improvement and provide actionable recommendations.

Qualifications:

• Bachelors degree in Medical.

• 5 years of experience in medical coding with a focus on oncology.
• Certified Professional Coder (CPC), Certified Coding Specialist (CCS), or other relevant certification required.
• In-depth knowledge of oncology-specific coding guidelines, including ICD-10, CPT, and HCPCS codes.
• Strong analytical, problem-solving, and decision-making skills.
• Excellent communication and interpersonal skills, with the ability to effectively collaborate with clinical and coding teams.
• Proficiency in coding software, Electronic Health Records (EHR) systems, and Practice Management Systems (PMS).