The role involves using clinical knowledge to manage complex ambulatory medical necessity denials through the appeals process at the James Cancer Center
Job Summary
The role involves using clinical knowledge to manage complex ambulatory medical necessity denials through the appeals process at the James Cancer Center.
Candidates will provide scientific evidence to support cutting-edge therapies and educate payers on current standard of care treatments.
The position requires proactive submission of pre-determination requests to mitigate revenue loss risks and support clinicians in identifying financial risks.
Matching Summary
The role involves using clinical knowledge to manage complex ambulatory medical necessity denials through the appeals process at the James Cancer Center.
Skills & Requirements
Must-have
Oncology clinical experience required
ICD-9-CM HCPCs CPT coding knowledge
Windows Excel Access navigation skills
Nice-to-have
Physician practice or utilization review experience