Description:

　　This position supports the research program in management post-award financial activities for research projects conducted for large community based hospital system. The primary function of the Research Billing Specialist is to review all research patient care items and services against a Medicare Coverage Analysis (MCA) and to segregate the charges by the applicable payor type. This role is based in the Central Research Department and supports multiple inpatient and outpatient practices. This role will manage research billing for oncology, cardiology, critical care and several other disease areas. This individual works closely with the Research Financial Analysts and Research Accountant.

　　PRIMARY DUTIES AND RESPONSIBILITIES:

　　Responsible for interpreting and applying the MCA to patient billing review

　　Responsible for working with Patient Access, the Business Office and the Accounting and Finance Department to ensure that all research charges are identified and treated appropriately

　　Track patient visits dates via the Clinical Trial Management System (CTMS) or multiple practice Electronic Medical Records

　　Identify new research patient accounts in the financial system using reports from the CTMS and add appropriate patient flag

　　Refer to study documents, such as the MCA, study protocol, informed consent form, Clinical Trial Agreement (CTA) and budget to review new research patient accounts for patient care charges associated with each clinical research project on a regular basis

　　Credit and charge accounts to create clean insurance accounts and research only charge accounts

　　Provide the hospital billing office and practice billing offices the appropriate modifiers and study information to be included on claims

　　Ensure that professional fees are adjusted the same way that technical fees are adjusted

　　Provide high quality customer service for patients enrolled on research studies by addressing questions or concerns about charges and following-up in a timely manner

　　Address research billing questions from research team members and other staff

　　Help educate research staff about the importance of regular and timely patient visit tracking as well as communication around study or patient status changes

　　Ensure corrections or adjustments are communicated to the billing office in a timely manner

　　Track overall bill hold amounts and ensure timely review and release of research accounts

　　Complete month-end billing review and release

　　Track when patients go off study and remove patient flag

　　Work with billing quality assurance team to ensure compliant and timely billing review

　　Prepare weekly report of research account standing

　　Skills:

　　Financial analysis, clinical research, Invoicing, budget review, report monitoring, Medicare Coverage Analysis, CTMS, EMR, CTA, Billing, patient care expenses, regulatory

　　Top Skills Details:

　　Financial analysis, clinical research, Invoicing, budget review, report monitoring, Medicare Coverage Analysis

　　Additional Skills & Qualifications:

　　Stay abreast of Medicare policy and regulatory documents to best inform the Medicare Coverage Analysis and patient care charge process

　　Demonstrate effective professional communication

　　Facilitate and model open communication among all staff involved in the conduct of clinical research

　　Maintain confidentiality in all aspects of communication

　　Foster professional presentation of verbal and written communications

　　Stay abreast of sponsoring agency policy and regulatory documents

　　Assist administration and management with the review, development and implementation of institutional policies and procedures to assist compliance with federal, state and local laws and regulations related to clinical research

　　Other duties as assigned

　　Experience Level:

　　Intermediate Level

　　Diversity, Equity & Inclusion

　　At Actalent, diversity and inclusion are a bridge towards the equity and success of our people. DE&I are embedded into our culture through:

　　Hiring diverse talent

　　Maintaining an inclusive environment through persistent self-reflection

　　Building a culture of care, engagement, and recognition with clear outcomes

　　Ensuring growth opportunities for our people

　　Actalent is an equal opportunity employer.

　　About Actalent

　　Actalent connects passion with purpose. We help visionary companies advance their engineering and science initiatives through access to specialized experts that drive scale, innovation, and speed to market. With a network of almost 30,000 engineering and sciences consultants and more than 4,500 clients across the U.S., Canada, Asia, and Europe, Actalent serves many of the Fortune 500. An operating company of Allegis Group, the global leader in talent solutions, Actalent launched as a new specialized engineering and sciences services and workforce solutions brand in 2021.