Role Description
The research billing coordinator is responsible for reviewing the clinical research patient accounts in comparison to the clinical trial protocol, contracts, consent form, and medical record to ensure that charges for items and services that are related to the study are properly billed. They work closely with the registration team, the coding manager, and the billing department to facilitate the identification of research patients and accurate claims processing. The employee responds to inquiries and audits patient accounts as needed to resolve issues that are identified. The employee also coordinates the monthly billing of study services to the research program.
Essential Functions:
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Reviews daily reports of research subject registrations and subject activity reported by clinical researchers and matches those to patient encounters to place holds for charge review and audit.
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Reviews patient charges and orders, coverage analysis, protocol, consent, and budget for research subjects encounters to determine which items need to be removed from carrier claims.
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Works with researchers and patient accounting/revenue cycle to ensure research subject encounters are identified and appropriate condition code & NCT# is provided for claims submitted to insurance carriers; removes research-related charges from claims and adds to queue to bill researchers.
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Works with revenue cycle team, clinical researchers, and external providers to establish communications and processes as needed to identify services provided to research patients and resolve inquiries in a timely manner.
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Converts full charge information to Invoice for research services and bills the research program when applicable; follows up on outstanding AR as needed.
Other Functions:
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Facilitates billing compliance by working on errors identified until full resolution and communicates with clinical research team as needed.
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Requests and/or builds research records in Epic, Cerner, Star as needed to facilitate research billing.
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Maintains compliance with all company policies, procedures, and standards of conduct.
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Complies with HIPAA privacy and security requirements to maintain confidentiality at all times.
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Performs other duties as assigned.
Qualifications
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Associate Degree in Business (preferred).
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Equivalent work experience acceptable.
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Two (2) years in healthcare finance, revenue cycle operations (required).
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Two (2) or more years in clinical research (preferred).
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Experience with medical terminology and/or medical coding (preferred).
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Certified Clinical Research Professional (CCRP), or Certified in Healthcare Research Compliance (CHRC), or Certified Professional Coder (CPC) (preferred).
Requirements
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Must have strong attention to detail.
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Must be very organized.
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Must have strong customer service focus.
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Must be able to switch between tasks with ease.
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Must be able to follow through until resolution.
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Must be able to communicate effectively in both verbal and written formats.
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Must be able to read and comprehend clinical protocols, coverage analysis, national and local coverage determinations, various contracts, budgets, consent forms, and other documents related to clinical research.
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Must be able to present facts as needed to assist others in understanding the situation.
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Proficient in MS Office: Excel, Word, and Outlook using tasks and reminders to stay on track.
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Cerner, Epic, STAR experience a plus; will be trained as needed.
Benefits
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Demonstrates a commitment to service, organization values, and professionalism through appropriate conduct and demeanor at all times.
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Maintains confidentiality and protects sensitive data at all times.
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Adheres to organizational and department-specific safety standards and guidelines.
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Works collaboratively and supports efforts of team members.
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Demonstrates exceptional customer service and interacts effectively with physicians, patients, residents, visitors, staff, and the broader health care community.
Company Description
UofL Health is a not-for-profit 501(c)(3) fully integrated regional academic health system with nine hospitals, four medical centers, Brown Cancer Center, Eye Institute, more than 250 physician practice locations, and more than 1,200 providers in Louisville and the surrounding counties, including southern Indiana. With more than 14,000 team members β physicians, surgeons, nurses, pharmacists, and other highly-skilled health care professionals, UofL Health is focused on one mission: to transform the health of communities we serve through compassionate, innovative, patient-centered care.