Clinical Research Revenue Integrity Analyst

Inova•VA, VA

8d•$73,778 - $120,257•Hybrid

About The Position

The Clinical Research Revenue Integrity Analyst is a part of the Clinical Research Support Office (CRSO) in the Office of Research at Inova. This position supports Inova researchers ensuring billing compliance in claims review of clinical trials. The employee will collaborate with others to ensure clinical research billing compliance. Inova is consistently ranked a national healthcare leader in safety, quality and patient experience. We are also proud to be consistently recognized as a top employer in both the D.C. metro area and the nation.

Requirements

Bachelor's degree; or Associate’s degree and 2 years relevant professional experience in addition to the minimum experience required; or HS Diploma/GED and 4 years relevant professional experience in addition to the minimum experience required
3 years of relevant experience

Nice To Haves

Experience in medical billing, with a strong understanding of insurance claims, appeals, and denial management preferred.
Experience working with Epic preferred.
Knowledge of Revenue Cycle processes and workflows preferred.

Responsibilities

Maintain consistent review of accounts receivable. This includes: Review charges daily that are in the Epic charge review workqueues and Epic reports to segregate them as research paid, routine care, or not study related.
Ensure technical and professional charges are segregated based on each study’s billing grid.
Apply appropriate billing modifiers and other requirements for billing research-related charges to federal and non-federal payors.
Processes charge related corrections, additions, and removals in Epic and the OnCore CTMS to ensure organizational compliance.
Refer to study documents (e.g. study protocol, informed consent form, Clinical Trial Agreement (CTA), billing grid) when reviewing research patient accounts to ensure maximum revenue from study fees through timely and accurate billing.
Communicate with study teams, revenue cycle teams, and others to resolve billing related issues.
Generates invoices in the OnCore CTMS based on the study’s Billing Grid and contract.
Track invoices from third-party vendors to ensure correct billing of research-related procedures. Collaborate with finance team to ensure vendors receive timely payment for services.
Collaborate with the PI/study team, Office of Research staff, and other Inova departments to determine accurate Current Procedural Terminology (CPT) coding for billable procedures. Serves as a resource to communicate with non-research departments to determine correct coding and charges.
Collaborates with the study teams and Office of Research personnel in the development and implementation of educational activities related to research billing compliance.
May assist other personnel in month end close of research accounts.