The Ohio State University Hiring for Clinical Financial Case Manager- The James at Remote Location Full Time

Screen reader users may encounter difficulty with this site. For assistance with applying, please contact [email protected]. If you have questions while submitting an application, please review these frequently asked questions.

Current Employees and Students:If you are currently employed or enrolled as a student at The Ohio State University, please log in to Workday to use the internal application process.

Welcome to The Ohio State University’s career site. We invite you to apply to positions of interest. In order to ensure your application is complete, you must complete the following:

• Ensure you have all necessary documents available when starting the application process. You can review the additional job description section on postings for documents that may be required.
• Prior to submitting your application, please review and update (if necessary) the information in your candidate profile as it will transfer to your application.

Job Title:Clinical Financial Case Manager- The James

Department:James | Precert and Financial Counseling

Scope of Position

The Clinical Financial Case Manager position is responsible for intervention and follow-up on accounts that require clinical interpretation and analysis along the revenue cycle. Primary focus will be the processing of accurate insurance appeals. This position requires a high level of clinical knowledge and the ability to use a work proficiently in the Integrated Health Information Systems (IHIS). In addition, this position provides support through education and communication to other departments such as MIM, PCRMs, Physicians, Nurse
Practitioners, PAs, and other clinical personnel. This position requires that the individual be able to identify trends and offers suggestions for process improvement to support avoidance of and recoupment of lost revenue.

Position Summary
Responsible for follow-up on rejected and denied claims using evidence based support and other documentation as needed. Works with Medical Information Management to ensure proper ICD10 and CPT4 coding are performed on each claim. Responsible for identifying trends in denials and providing education to
clinical staff and managed care payers to reduce these denials; Provide clinical support to non-clinical precertification staff as needed. Must have a strong understanding of the disease implications, use of various treatment modalities, and expected outcomes.

Minimum Qualifications

For Hire: Associate’s degree required, nursing major preferred or equivalent experience. Minimum of 3 years experience in the field of oncology with solid clinical skills and current clinical practices preferred. Experience with Windows, Excel, Access, and Intranet/internet navigation tools. 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.
.
On going: Attends continuing education seminars on job-related topics to maintain credentials. Maintains CEUs for RN license requirements. Stays current in oncology and the associated treatment modalities.

Additional Information:

Location:Remote Location

Position Type:Regular

Scheduled Hours:40

Shift:First Shift

Final candidates are subject to successful completion of a background check. A drug screen or physical may be required during the post offer process.

Thank you for your interest in positions at The Ohio State University and Wexner Medical Center. Once you have applied, the most updated information on the status of your application can be found by visiting the Candidate Home section of this site. Please view your submitted applications by logging in and reviewing your status. For answers to additional questions please review the frequently asked questions.

The Ohio State University is an equal opportunity employer.

All qualified applicants will receive consideration for employment without regard to age, ancestry, color, disability, ethnicity, gender identity or expression, genetic information, HIV/AIDS status, military status, national origin, race, religion, sex, gender, sexual orientation, pregnancy, protected veteran status, or any other basis under the law.

Applicants are encouraged to complete and submit the Equal Employment Identification form.