Inside Higher Ed
Clinical Financial Case Management Specialist 2
Inside Higher Ed, Columbus, Ohio, United States, 43224
Overview
Clinical Financial Case Management Specialist 2 Join to apply for the Clinical Financial Case Management Specialist 2 role at Inside Higher Ed. Responsibilities
Use clinical knowledge for the management of complex James Cancer Center ambulatory medical necessity denials through the appeals process. Provide scientific evidence to support cutting edge therapies, and diagnostic services. Provide clinical education to payers regarding current standard of care treatment and other frequently denied services as applicable. Identify trends and areas for needed clinical education, to decrease denials where applicable. Submit pre-determination requests proactively supporting clinicians in efforts to identify areas where loss of revenue is at risk to mitigate that risk. Provide support to the CBO Medicare billing area in the form of correcting billing errors before the bill is sent to the payer. Provide clinical support for the review of clinical data to access current policies and processes impacting revenue. Provide coverage support to the pre-certification area when clinical intervention is required. Qualifications
Associate Degree in Nursing preferred. Minimum of 3 years oncology experience preferred. Experience with Windows, Excel, Access, and Intranet/internet navigation tools. Minimum of 3 years experience in the field of oncology with solid clinical skills and current clinical practices required. Experience in physician practice, and/or utilization review a plus. Knowledge of Medicare and commercial insurance reimbursement preferred. Strong knowledge of ICD-9-CM, HCPCS, and CPT coding preferred. Excellent verbal and written skills required. Proficient in the use of computer based research and medical record documentation required. Use of computer based billing systems, and databases a plus. Details
Location: Doan Hall (0089) Position Type: Regular Scheduled Hours: 40 Shift: First Shift Additional Information
Final candidates are subject to successful completion of a background check. A drug screen or physical may be required during the post offer process. The university is an equal opportunity employer, including veterans and disability. Referrals increase your chances of interviewing at Inside Higher Ed by 2x. Get notified about new Clinical Specialist jobs in Columbus, OH.
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Clinical Financial Case Management Specialist 2 Join to apply for the Clinical Financial Case Management Specialist 2 role at Inside Higher Ed. Responsibilities
Use clinical knowledge for the management of complex James Cancer Center ambulatory medical necessity denials through the appeals process. Provide scientific evidence to support cutting edge therapies, and diagnostic services. Provide clinical education to payers regarding current standard of care treatment and other frequently denied services as applicable. Identify trends and areas for needed clinical education, to decrease denials where applicable. Submit pre-determination requests proactively supporting clinicians in efforts to identify areas where loss of revenue is at risk to mitigate that risk. Provide support to the CBO Medicare billing area in the form of correcting billing errors before the bill is sent to the payer. Provide clinical support for the review of clinical data to access current policies and processes impacting revenue. Provide coverage support to the pre-certification area when clinical intervention is required. Qualifications
Associate Degree in Nursing preferred. Minimum of 3 years oncology experience preferred. Experience with Windows, Excel, Access, and Intranet/internet navigation tools. Minimum of 3 years experience in the field of oncology with solid clinical skills and current clinical practices required. Experience in physician practice, and/or utilization review a plus. Knowledge of Medicare and commercial insurance reimbursement preferred. Strong knowledge of ICD-9-CM, HCPCS, and CPT coding preferred. Excellent verbal and written skills required. Proficient in the use of computer based research and medical record documentation required. Use of computer based billing systems, and databases a plus. Details
Location: Doan Hall (0089) Position Type: Regular Scheduled Hours: 40 Shift: First Shift Additional Information
Final candidates are subject to successful completion of a background check. A drug screen or physical may be required during the post offer process. The university is an equal opportunity employer, including veterans and disability. Referrals increase your chances of interviewing at Inside Higher Ed by 2x. Get notified about new Clinical Specialist jobs in Columbus, OH.
#J-18808-Ljbffr