Medical Records Case Manager (Oncology)

TL;DR

Medical Records Case Manager (Oncology): Facilitating medical records collection and client outreach to support documentation of medical necessity with an accent on interpreting clinical data and navigating insurance coverage guidelines. Focus on collaborating with billing operations and clinical departments to ensure compliance and revenue cycle performance.

Location: Must be based in the United States

Salary: $27–$34 USD per hour

Company

hirify.global is a global leader in cell-free DNA (cfDNA) testing, dedicated to oncology, women’s health, and organ health.

What you will do

• Collaborate as a primary liaison between billing operations, customer experience groups, and clinic medical records departments.
• Review and interpret medical records, including provider progress notes, to identify and summarize data points meeting medical necessity.
• Navigate and extract data from electronic medical records systems, including EPIC.
• Ensure all activities are documented and conducted in compliance with HIPAA and PHI privacy standards.
• Participate in weekly meetings, case reviews, and continuing education to track key metrics and performance trends.

Requirements

• Must be based in the United States
• At least 3 years of relevant experience in healthcare administration, case management, nursing, or medical billing/coding.
• Bachelor's degree in a healthcare-related field or equivalent clinical experience.
• Thorough knowledge of CMS, state, and insurer medical policy and coverage guidelines (LCD & NCD).
• In-depth understanding of oncology and organ health terminology.
• Proficiency with G-Suite products and strong analytical skills.

Culture & Benefits

• Comprehensive medical, dental, vision, life, and disability plans.
• Free genetic testing for employees and immediate families.
• Fertility care benefits and pregnancy/baby bonding leave.
• 401k retirement benefits.
• Generous employee referral program.