Compliance Auditor& Billing Analyst - Oncology

McKesson is an impact-driven company that touches virtually every aspect of healthcare. We focus on the health, happiness, and well-being of you and those we serve.

Position Description
:
Under minimal supervision, the Health Care Coding & Billing Analyst is responsible for performing data-driven coding and billing reviews, validating reimbursement accuracy, and assessing compliance with federal and state regulatory requirements. This role combines advanced analytical skills with knowledgeable application of CPT, HCPCS, ICD
10CM
, E/M guidelines, and payer-specific billing rules. The analyst will support Network practices through audit activities, data interpretation, coding validation, and identification of trends or areas needing improvement. The position requires close collaboration with clinical staff, coding teams, billing operations, and Compliance leadership to ensure revenue integrity and regulatory adherence. Strong communication skills are essential - the analyst must effectively communicate complex coding, billing, and data findings to providers and operational teams.

This position supports and adheres to the US Oncology Compliance Program including the Code of Ethics and Business Standards.

• Conduct coding and billing reviews, audits, and quality assurance procedures in accordance with compliance department standard operating procedures.
• Comprehend and adhere to department procedures related to billing and coding audits and reviews.
• Prepare reports of findings and recommendations for improvement for internal review and distribution to business leaders and compliance leadership.
• Collaborate with the education group to ensure that audit findings are accurate and accessible for training purposes.
• Maintain up-to-date knowledge of E&M, CPT, HCPCS and ICD-10-CM coding and coding guidelines.
• Perform reviews, audits, and quality assurance of final audit product using medical records to assess the documentation against base code sets impacting payment, ensuring compliance with Medicare, Medicaid, and other federal payor guidelines.
• Validate E&M, CPT, HCPCS and ICD-10-CM codes assigned for Medicare, Medicaid, and other government payors based on provider selection.
• Document results and necessary corrections clearly, providing supporting evidence from medical records and authoritative guidance.
• Conduct auditing quality checks (QC) reviews to ensure billing and coding audits are performed in alignment with departmental procedures and Federal Payer guidelines, and that resulting reports are accurate and consistent with authoritative guidelines and department standards.
• Occasionally delivers targeted education to providers based on audit findings, including one-on-one sessions and collaborative calls, to support compliance with documentation and coding standards.
• Perform other job duties as assigned.
• Meet or exceed production, quality, and department goals as established for the department.
• Data analysis, reporting, and interpretation
• Supporting audits, quality reviews, or process monitoring (as applicable)
• Identifying trends, variances, or operational issues
• Ability to compare datasets to specifications, identify gaps, ensure data integrity
• Use of analytical tools and multiple data sources; sensechecking and validating insights before delivery
• Understanding data governance, data quality, and documentation standards
• Following structured processes for analysis, validation, and implementation
• Workstream ownership-organizing tasks, updating leadership, and driving deliverables forward
• Cross functional collaboration with business, operations, or IT

Ability to work independently with urgency, high attention to detail, proficiency with Microsoft Office and analytic tools such as SQL, Visio, Project, Smartsheet, and AI tools like Copilot; strong communication and critical-thinking skills.

4+ years of healthcare coding, billing, auditing, or revenue integrity experience; 4+ years coding experience using CPT, ICD
10CM
, HCPCS, and E/M; active CPC/COC/or ROCC certification; 1-2+ years analytical or reporting experience.

Current CPC required; CPMA/CCSP/CRC preferred; bachelor's degree in HIM, healthcare administration, data analytics, or related field preferred; proficiency with Excel, SQL, or reporting tools.

Strong understanding of federal payor regulations, reimbursement rules, coding guidelines, medical terminology, documentation requirements, and ability to analyze datasets to identify billing/coding risks.

General office demands; flexible working hours may be required.

Must be…