Analyzes and codes clinical trial patient records according to Clinical Trial Policy National Coverage Determination coding conventions/guidelines, and as guided by government, third party and regulatory guidelines. Abstracts codes to facilitate an accurate database for research, planning, statistics and financial reimbursement.

Responsibilities:

Performs daily review and reconciliation of billing edits for patients on industry sponsored trials.

Verifies eligibility of clinical trail patients from database (clinical trials management system (CTMS) OnCore).

Review all industry sponsored claims with Pre-Award department before releasing to ensure the internal budget matches patient bills.

Provides daily statistical reporting to Management of Productivity Measurements.Analyzes charges and codes utilizing ICD-9-CM and/or CPT-4 (HCPCS) coding methodologies to include appropriate modifiers where warranted, while adhering to national coding guidelines for correct coding.

Clarifies inconsistent, ambiguous or non-specific information in the patient billing record by consulting the medical record.

Bachelor’s Degree required with minimum of 3-4 years previous work experience in patient accounting; or equivalent combination of education and experience.

Demonstrated understanding of ICD-9-CM, CPT-4 (HCPCS) coding protocols, and government regulations. Knowledge of edit reports in advance of electronic billing preferred.

Knowledge of accounts invoices and accounts receivable preferred.

Comprehensive knowledge of medical terminology, anatomy physiology, pharmacology, disease processes, surgical and medical procedures.

Computer application skills: Windows, Word, Excel, Outlook, Oncore and CITRIX/CIS.Equal Opportunity Employer of Minorities/Females/Disabled/Veterans