Oncology RCM Specialist: Patient Access & Reimbursement

Knoxville Hospital; Knoxville (IA); On-site; USD 45,000 - 65,000; Full time

Job summary

Knoxville Hospital is seeking an Oncology Revenue Cycle Specialist to manage end-to-end billing for oncology services, including verification, prior authorization, coding, and denial resolution. You will collaborate with oncology providers, nursing, infusion, pharmacy, scheduling, and payers to ensure timely access to care and accurate reimbursement.

The role requires strong knowledge of insurance terminology, effective communication, and the ability to work independently.

Qualifications

• Knowledge of medical/healthcare and insurance terminology.
• Adequate written and oral communication skills; ability to work independently.
• Mandatory Reporter training certification or completion within 30 days of hire.

Responsibilities

• Serve as the primary revenue cycle resource for oncology services, managing insurance verification, prior authorizations, billing, reimbursement follow-up, and denial resolution.
• Verify insurance eligibility and coverage requirements for oncology treatments and related services.
• Obtain and track prior authorizations for chemotherapy, immunotherapy, and infusion therapies.
• Coordinate with providers, nursing staff, pharmacy, and payers to resolve authorization and reimbursement issues.
• Review, submit, and follow oncology claims to ensure timely reimbursement and accurate submissions.
• Investigate and resolve claim denials and underpayments, including appeals when necessary.
• Monitor outstanding accounts and payer responses to support timely resolution.

Skills

Insurance terminology

Written communication

Independent work

Healthcare revenue cycle knowledge

Education

High School Diploma or GED

Job description

Knoxville Hospital is seeking an Oncology Revenue Cycle Specialist to manage end-to-end billing for oncology services, including verification, prior authorization, coding, and denial resolution. You will collaborate with oncology providers, nursing, infusion, pharmacy, scheduling, and payers to ensure timely access to care and accurate reimbursement.

The role requires strong knowledge of insurance terminology, effective communication, and the ability to work independently.