Research Billing Compl Anly - Research Administration - 004

We’re looking for a Research Billing Compliance Analyst, someone who’s ready to grow with our company. In this position, you’ll be responsible for reviewing and processing clinical research billing activities for clinical trials and other clinical research studies. This role tracks and reviews clinical research billing grids and reviews pre-billed and billed charges related to clinical research. This role interacts with clinical research study teams, IS-EPIC, and other team members to reduce the risk of inappropriately billing patients and/or third parties for research related services/procedures.

Think you’ve got what it takes?

Communicates effectively across various teams, including Clinical Trial Managers, Office of IRB, Academic Office of Clinical Research, Grants and Contracts, Internal Audit, Institutional Billing, and Hospital Finance

Receives initial protocol packages from Principal Investigators

May attend feasibility meetings

Communicates with the Principal Investigator, research nurses, and study coordinators to discuss study design and determine which items are standard of care versus research care

Works closely with Senior Billing Compliance Analysts and BCM’s Office of Research to ensure the accuracy of billing grids

Completes timely pricing quotes for clinical trials and studies conducted at TCH within institutional and Medicare guidelines

Collects financial data (both manually and automatically) from several institutional databases and systems

Uses spreadsheets and database software to analyze charge, cost, and collection data for patients participating in clinical trials

Prepares monthly statements and invoices for review and payment by the Principal Investigator for clinical research charges per study

Maintains spreadsheets of study accounts and write-offs sent to Financial Services and Patient Accounting for institutional processing and tracking

Maintains and updates clinical trials in the Epic system (online medical record system)

Processes and reviews clinical research charges in Epic for both technical and professional charges

Accesses institutional charge masters to provide pricing for procedures using both SIMS and CPT codes

Accesses BRAIN to ensure the accuracy of IRB protocol information and verify approval

Accesses the Clinical Trials Management System (CTMS) to ensure appropriate billing modifiers are used on billing grids

Conducts clinical research billing audits of study records upon request or as needed.

Participates in cross-training with other staff on the Research Billing Compliance team

Learns FDA device regulations, CMS billing guidelines, and appropriate billing rules for various populations

Conducts and completes special projects as assigned and defined by the Assistant Director and/or Director within established timelines determined at project inception and by project participants and circumstances

Develops budgets for sponsors

Bachelor's Degree Business or Hospital Administration or a related field required

CPC — Certified Professional Coder, American Academy of Professional Coders preferred

RHIA — Registered Health Information Administrator, American Health Information Management Association preferred

RHIT — Registered Health Information Technician, American Health Information Management Association preferred

CCRP — Certified Clinical Research Professional, Society of Clinical Research Associates preferred

CRA — Certified Research Administrator, Research Administrators Certification Council preferred

1 year Experience in research, billing, compliance, finance or Health Care Administration preferred

Familiarity with clinical trial study design, coordination and/or management preferred