The Oncology Revenue Integrity Specialist is a full-time, on-site role based in Cleveland, OH, focused on ensuring accurate and compliant oncology and hematology billing and revenue capture.
The role reviews clinical documentation, coding, and charge processes to identify discrepancies, optimize reimbursement, and maintain adherence to payer rules and regulatory requirements. The specialist collaborates with oncology providers, clinical staff, billing teams, and Medical Affairs to clarify documentation, support accurate coding, and resolve denials or underpayments.
Daily responsibilities include conducting audits, analyzing revenue trends, supporting process improvements, preparing reports and recommendations to strengthen revenue integrity, and contributing to staff education on oncology-specific coding, billing practices, and compliance standards.
Candidates should possess:
- Strong knowledge of oncology and hematology to accurately interpret clinical documentation and treatment plans.
- Expertise in medicine and medical affairs to collaborate effectively with clinicians and align clinical and administrative standards.
- Solid research and analytical skills to identify revenue integrity issues and support process improvement.
- Proven experience with healthcare revenue cycle, coding (CPT, HCPCS, ICD), and billing practices, preferably in an oncology setting.
- Proficiency in regulatory compliance, payer guidelines, and documentation standards related to oncology services.
- Strong problem-solving, detail-oriented, and communication skills.
- Ability to work collaboratively with interdisciplinary teams and provide clear education and feedback.
- Relevant certifications such as CPC, CCS, or CHONC are highly beneficial.
Location
Cleveland, Ohio, US
Employment Type
Full-time
Experience Level
Entry Level
Remote work allowed
No
Posted
3 weeks ago