Oncology Revenue Integrity Specialist II

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

Job summary

A leading healthcare institution in Columbus, Ohio is seeking a Clinical Financial Case Management Specialist 2 to manage complex medical necessity denials and support clinicians in optimizing revenue. The ideal candidate has a strong oncology background, excellent communication skills, and proficiency in medical coding and reimbursement processes. This role aims to uphold high standards of patient care while reducing revenue loss.

Qualifications

• Minimum of 3 years oncology experience preferred.
• Strong knowledge of clinical practices required.
• Experience in physician practice and/or utilization review a plus.

Responsibilities

• Manage complex medical necessity denials through the appeals process.
• Provide education and clinical support to the team.
• Facilitate hospital reimbursement related to patient services.

Skills

Oncology experience

Excellent verbal and written skills

Knowledge of Medicare and commercial insurance reimbursement

Proficient in Windows, Excel, Access

Education

Associate Degree in Nursing

Tools

Computer-based billing systems

ICD-9-CM, HCPCS, and CPT coding

Job description

A leading healthcare institution in Columbus, Ohio is seeking a Clinical Financial Case Management Specialist 2 to manage complex medical necessity denials and support clinicians in optimizing revenue. The ideal candidate has a strong oncology background, excellent communication skills, and proficiency in medical coding and reimbursement processes. This role aims to uphold high standards of patient care while reducing revenue loss.