Oncology Reimbursement & Pre-Certification Specialist

Inside Higher Ed; Columbus (OH); On-site; USD 60,000 - 80,000; Full time

Job summary

A health management organization seeks a Clinical Financial Case Manager for its Columbus office. The role involves managing rejected and denied insurance claims, ensuring correct coding practices, and educating clinical staff. Candidates should have at least an associate degree in nursing and a minimum of three years in oncology, with strong clinical knowledge and coding skills. The position offers a regular schedule with first shift hours.

Qualifications

• Minimum of 3 years oncology experience expected.
• Strong understanding of disease implications and treatment modalities.
• Excellent verbal and written skills required.

Responsibilities

• Follow up on rejected and denied claims using evidence-based support.
• Work with Medical Information Management for proper coding.
• Provide educational support to reduce denial trends.

Skills

Clinical skills in oncology

Verbal and written communication

Knowledge of ICD-10-CM and CPT coding

Experience with Windows and Excel

Education

Associate or Bachelor Degree in Nursing

Tools

Computer-based billing systems

Medical record documentation

Job description

A health management organization seeks a Clinical Financial Case Manager for its Columbus office. The role involves managing rejected and denied insurance claims, ensuring correct coding practices, and educating clinical staff. Candidates should have at least an associate degree in nursing and a minimum of three years in oncology, with strong clinical knowledge and coding skills. The position offers a regular schedule with first shift hours.