[Hiring] Clinical Trials Revenue Cycle Billing Compliance @Vanderbilt University Medical Center

Role Description

The Regulatory Oversight Specialist – Research (non-supervisory) is responsible for planning and leading projects related to the management of clinical research. Reviews will include but may not be limited to performing prospective review of study protocols, billing grid development and research charge segregation activities. Study activities reviewed evaluate compliance with CMS regulations for billing of research studies.

• Perform prospective reviews of research related/clinical trial processes impacting billing integrity.
• Assist with audits of study protocols, Medicare Coverage Analysis, and charge segregation functions.
• Initiate and plan projects with autonomy and provide summaries of issues to executive leadership.
• Analyze impacts to insurance and patient billing as part of project assignments.
• Work independently with strong analytical and regulatory knowledge.
• Assemble and analyze data in Excel, review transactions in EPIC, and provide PowerPoint summaries.

Qualifications

• Bachelor’s Degree and 10 years of relevant work experience in Research Administration, Clinical Trials Management, Revenue Cycle, Consulting, or Auditing in a Large Academic Medical Center.
• CHRC (Certification in Healthcare Research Compliance) and/or CHC (Certified in Healthcare Compliance) preferred.
• Familiarity with OnCore Clinical Trials Management System strongly preferred.

Requirements

• Lead prospective and retrospective reviews of study protocols and billing grid development.
• Analyze compliance with CMS regulations for billing of research studies.
• Perform special projects related to compliance matters as requested.
• Analyze data files in Excel and document findings and recommendations.
• Lead complex financial, operational, reimbursement, and business analyses.
• Interpret and communicate analytical findings to leadership.
• Support legal, compliance, and research administration leadership.
• Promote standardization and best practices across financial processes.
• Identify opportunities to leverage technology and analytics for improvement.
• Foster a culture of accountability, collaboration, and continuous improvement.
• Maintain updated knowledge of federal and state regulatory changes.
• Contribute to major finance department projects and organizational priorities.
• Perform other duties as assigned.

Benefits

• Comprehensive benefits package including health, disability, retirement, and wellness offerings.
• Support for professional growth and a sense of community and purpose.