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 Clinical Documentation Improvement (CDI) Specialist, QA will be responsible for reviewing patient medical records to ensure documentation is accurate, complete, and specific. This supports proper patient care, accurate coding and billing, and improved quality data. This role will report directly to the RCM Coding QA Manager.

Responsibilities:

• Perform regular reviews of patient charts to assess the completeness, accuracy, and specificity of the documentation.

• Communicate directly with physicians, nurses, and other caregivers to resolve documentation discrepancies, obtain additional details about a patient's condition, and ensure the documentation fully supports the care provided.

• Develop documentation standards for provider documentation (Op notes, orders, progress notes etc).

• Provide education and training to clinical staff, such as physicians and nurses, on best practices for medical recordkeeping, documentation criteria, and coding principles.

• Work with EMR product owners on creating compliant templates for provider documentation.

• Maintain compliance with federal, state, and payor requirements and regulations, such as HIPAA, within medical documentation.

• Generate qualitative analytics reports on key metrics to help the organization monitor performance and identify areas for intervention and improvement.

• Participate in audits for EM level accuracy and appropriate modifier utilization.

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

Key Competencies:

• Demonstrate positive and professional behavior in the workplace.

• Ability to build and maintain trusting relationships.

• Knowledge of clinic office procedures, medical practice, and RCM.

• Strong organizational skills and attention to detail.

• Strong understanding of human anatomy, physiology, and medical terminology.

• Ability to meet deadlines and work in a fast-paced, matrixed environment.

• Proficient in the use of end-user computer applications regarding productivity (MS Word, Excel, Outlook, payer sites), database and patient scheduling and other medical information systems.

• Excellent written and verbal communication skills required to effectively interact with healthcare providers.

Qualifications:

• CPC, CCS, RHIA , RHIT or other core coding credentials required.

• CDIP, CCDS, CPMA or other clinical documentation certification preferred.

• Clinical background preferred.

• 3+ years coding and/or auditing experience required

• Strong technical skills in Microsoft Office Suite (Word, Excel, PowerPoint).

• Extensive knowledge of insurance payer guidelines, medical policies, clinical knowledge, and billing guidelines required.

• Strong knowledge of Joint Commission and other regulatory compliance standards.

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