Oncology Finance Case Manager — Denials & Appeals

The Ohio State University; Columbus (OH); On-site; USD 60,000 - 80,000; Full time

Job summary

The Ohio State University is seeking a Clinical Finance Case Management Specialist 2 for the James Cancer Center in Columbus. This role involves managing complex medical necessity denials and providing clinical education to payers about standard treatments and services.

The ideal candidate will have at least 3 years of oncology experience and a nursing degree. Responsibilities include building relationships with staff, handling reimbursement, and ensuring compliance with clinical business practices.

Qualifications

• Minimum of 3 years oncology experience required.
• Solid clinical skills with current clinical practices needed.
• Experience in physician practice and/or utilization review preferred.

Responsibilities

• Manage complex cancer center ambulatory medical necessity denials through appeals.
• Provide education on current standard of care treatments.
• Facilitate compliance and strong business practices.

Skills

Clinical skills in oncology

Excellent verbal and written communication skills

Proficiency in computer-based research

Knowledge of Medicare and insurance reimbursement

Strong knowledge of coding (ICD-9-CM, HCPCS, CPT)

Education

Associate Degree in Nursing

Tools

Windows

Excel

Access

Job description

The Ohio State University is seeking a Clinical Finance Case Management Specialist 2 for the James Cancer Center in Columbus. This role involves managing complex medical necessity denials and providing clinical education to payers about standard treatments and services.

The ideal candidate will have at least 3 years of oncology experience and a nursing degree. Responsibilities include building relationships with staff, handling reimbursement, and ensuring compliance with clinical business practices.