Clinical Financial Case Mgr

The Clinical Financial Case Manager is responsible for follow-up on rejected and denied claims using evidence-based support and other documentation as needed. They work with Medical Information Management to ensure proper ICD10 and CPT4 coding are performed on each claim and identify trends in denials to provide education to clinical staff and managed care payers to reduce these denials.

Requirements

• Associate or Bachelor Degree in Nursing preferred
• Minimum of 3 years oncology experience expected
• 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 expected
• Strong knowledge of ICD-10-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

Benefits

• Generous Paid Time Off
• 401k Matching
• Health Insurance
• Life Insurance
• Retirement Plan