Job Summary
A genetic testing and diagnostics company is searching for a person to fill their position for a Telecommute Oncology and Genetic Testing Denials and Appeals Director in San Carlos.
Core Responsibilities Include:
- Developing and implementing Standards of Practice for the Oncology and Genetic Testing Denials and Appeals Specialists
- Managing and prioritizing timely review, investigation and response to Oncology and Genetic Testing Denials
- Assisting with the development, maintenance, and management of cases utilizing an internal tracking tool for the distribution of reports
Required Skills:
- Travel rarely required (0-10%)
- Bachelors’ Degree in Nursing or other Clinical Practice field
- 5-7 years of Clinical RN experience including 5 years in Denial Management, Case Management, or related experience and 3 years of current experience with reimbursement methodologies
- Current and valid Registered Nursing License
- Experience with Interqual and or Milliman Disease Management Ideologies
- Experience preparing appeals for oncology, genetic testing or clinical denials
