Coder Certified

Job Details
Coder Certified

Job Description

The Certified Radiation Oncology Coder is responsible for accurate coding, charge capture, and compliance related to professional and technical services provided within the radiation oncology department. This role ensures that clinical documentation is translated into appropriate CPT, HCPCS, and ICD-10 codes in accordance with regulatory guidelines, payer policies, and departmental standards. The coder works closely with physicians, physicists, dosimetrists, therapists, and revenue cycle teams to optimize reimbursement, maintain compliance, and support efficient revenue cycle operations.

Essential Functions

• Review clinical documentation and treatment records to assign accurate CPT, HCPCS, and ICD-10-CM codes for radiation oncology services. • Code professional and technical services including simulation, treatment planning, dosimetry, treatment delivery, image guidance, and on-treatment visits. • Ensure correct coding for complex treatment modalities such as IMRT, SBRT, SRS, brachytherapy, and adaptive radiotherapy when applicable. • Verify charges for treatment management codes and appropriate frequency of billing. • Review and reconcile charge capture reports to ensure all services are billed appropriately. • Secures authorization and certification for patient services and verifies third-party insurance coverage and benefits for Radiation Oncology patients. • Other duties as assigned by supervisory / management staff of the department. • Maintain an accuracy rate minimally consistent with CMS regulations and internal reimbursement expectations - Accuracy rate of not less than 95% based on internal performance improvement reviews.

Competencies:

• Collaborate with billing teams to resolve claim edits, denials, and coding-related payer inquiries. • Provide coding clarification to revenue cycle and compliance teams. • Assist with root-cause analysis of denials related to coding or documentation issues. • Support optimization of reimbursement through proper charge capture and coding accuracy. • Provide guidance to physicians and clinical staff on documentation best practices for radiation oncology coding. • Understanding of Medicare, commercial payer, and radiation oncology billing rules • Stay current with changes in CPT, HCPCS, ICD-10, Medicare regulations, and payer policies. • Participate in departmental initiatives to improve coding workflows, compliance, and revenue integrity. • Strong knowledge of radiation oncology procedures, workflows, and terminology • Strong attention to detail and analytical skills

• Ability to interpret clinical documentation and complex treatment plans • Excellent communication and collaboration skills • Proficiency in electronic health records and billing systems

Education:

• High school diploma or equivalent required

• Associate's or Bachelor's degree in Health Information Management, Healthcare Administration,

or related field preferred

• One or more of the following:

o CPC (Certified Professional Coder) - American Academy of Professional Coders

o CCS (Certified Coding Specialist) - American Health Information Management

Association

Experience:

• Minimum 2-3 years of medical coding experience required

• Radiation oncology coding experience strongly preferred

• Experience with electronic health records and oncology information systems preferred

Minimum Certifications, Registration or License Requirements:

CPC or CCS required.

Work Shift
Workday Day (United States of America)

Worker Sub Type
Regular

Employee Entity
Thomas Jefferson University Hospitals, Inc.
Primary Location Address
111 S 11th Street, Philadelphia, Pennsylvania, United States of America

Nationally ranked, Jefferson, which is principally located in the greater Philadelphia region, Lehigh Valley and Northeastern Pennsylvania and southern New Jersey, is reimagining health care and higher education to create unparalleled value. Jefferson is more than 65,000 people strong, dedicated to providing the highest-quality, compassionate clinical care for patients; making our communities healthier and stronger; preparing tomorrow's professional leaders for 21st-century careers; and creating new knowledge through basic/programmatic, clinical and applied research. Thomas Jefferson University, home of Sidney Kimmel Medical College, Jefferson College of Nursing, and the Kanbar College of Design, Engineering and Commerce, dates back to 1824 and today comprises 10 colleges and three schools offering 200+ undergraduate and graduate programs to more than 8,300 students. Jefferson Health, nationally ranked as one of the top 15 not-for-profit health care systems in the country and the largest provider in the Philadelphia and Lehigh Valley areas, serves patients through millions of encounters each year at 32 hospitals campuses and more than 700 outpatient and urgent care locations throughout the region. Jefferson Health Plans is a not-for-profit managed health care organization providing a broad range of health coverage options in Pennsylvania and New Jersey for more than 35 years.

Jefferson is committed to providing equal educational and employment opportunities for all persons without regard to age, race, color, religion, creed, sexual orientation, gender, gender identity, marital status, pregnancy, national origin, ancestry, citizenship, military status, veteran status, handicap or disability or any other protected group or status.

Benefits

Jefferson offers a comprehensive package of benefits for full-time and part-time colleagues, including medical (including prescription), supplemental insurance, dental, vision, life and AD&D insurance, short- and long-term disability, flexible spending accounts, retirement plans, tuition assistance, as well as voluntary benefits, which provide colleagues with access to group rates on insurance and discounts. Colleagues have access to tuition discounts at Thomas Jefferson University after one year of full time service or two years of part time service. All colleagues, including those who work less than part-time (including per diem colleagues, adjunct faculty, and Jeff Temps), have access to medical (including prescription) insurance.

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