Job Title: Oncology Claims Denial Management Specialist / Analyst
Experience Required: 3–4 years (minimum) in Oncology Claims Denial Management, and
Revenue Cycle Management (RCM)
Job Summary:
We are seeking an experienced Oncology Claims Denial Management Specialist to manage and resolve complex AR and denial queues within oncology billing. The ideal candidate will have strong working knowledge of oncology-specific billing nuances, payer denial trends, and coding-related rejections, and will play a key role in improving collections and reducing denial turnaround time.
Key Responsibilities:
●Investigate and resolve denials related to:
○Drug and administration (admin) codes (e.g., chemotherapy drugs,J-codes, infusion/injection billing)
○E&M coding issues, including CPT, Dx (ICD-10), and modifier-related denials
- Analyze and identify recurring trends in underpayments, payer rejections, and denial root causes; recommend corrective action plans.
- Draft and submit appeals with appropriate clinical/coding documentation where required.
- Collaborate with coding, billing, and authorization teams to prevent recurring denials.Maintain accurate documentation of denial trends, resolutions, and follow-up actions in the billing system.
Meet productivity and quality standards for AR follow-up and denial resolution. Stay updated on payer-specific policies, oncology billing guidelines, and coding updates (CPT/HCPCS/ICD-10).
Required Skills & Qualifications:
3–4+ years of hands-on experience in Oncology Denial Management .
Strong understanding of drug/admin code billing (chemotherapy, infusion, injectables) and related denials.
Working knowledge of CPT, Dx (ICD-10), and modifier usage, especially in E&M coding.
Ability to identify denial patterns/trends and propose process improvements.Familiarity with payer guidelines (Medicare, Medicaid, Commercial payers) related to oncology claims.
Strong analytical, problem-solving, and communication skills.
Proficiency with billing/EHR systems (e.g., Epic, athenahealth, or similar —customize as per your organization).
Preferred Qualifications:
Certification in Medical Billing/Coding (CPC, CPB, or equivalent) is a plus.
Prior experience specifically in US healthcare RCM/oncology practices.
Pay: ₹400,000.00 - ₹700,000.00 per year
Work Location: In person
