Research Billing Compl Anly - Research Administration - 004

Texas Children's Medical Center•Houston, TX

About The Position

We’re looking for a Research Billing Compliance Analyst, someone who’s ready to grow with our company. In this position, you’ll be responsible for reviewing and processing clinical research billing activities for clinical trials and other clinical research studies. This role tracks and reviews clinical research billing grids and reviews pre-billed and billed charges related to clinical research. This role interacts with clinical research study teams, IS-EPIC, and other team members to reduce the risk of inappropriately billing patients and/or third parties for research related services/procedures.

Requirements

Bachelor's Degree Business or Hospital Administration or a related field required
1 year Experience in research, billing, compliance, finance or Health Care Administration preferred
Familiarity with clinical trial study design, coordination and/or management preferred

Nice To Haves

CPC — Certified Professional Coder, American Academy of Professional Coders preferred
RHIA — Registered Health Information Administrator, American Health Information Management Association preferred
RHIT — Registered Health Information Technician, American Health Information Management Association preferred
CCRP — Certified Clinical Research Professional, Society of Clinical Research Associates preferred
CRA — Certified Research Administrator, Research Administrators Certification Council preferred

Responsibilities

Communicates effectively across various teams, including Clinical Trial Managers, Office of IRB, Academic Office of Clinical Research, Grants and Contracts, Internal Audit, Institutional Billing, and Hospital Finance
Receives initial protocol packages from Principal Investigators
May attend feasibility meetings
Communicates with the Principal Investigator, research nurses, and study coordinators to discuss study design and determine which items are standard of care versus research care
Works closely with Senior Billing Compliance Analysts and BCM’s Office of Research to ensure the accuracy of billing grids
Completes timely pricing quotes for clinical trials and studies conducted at TCH within institutional and Medicare guidelines
Collects financial data (both manually and automatically) from several institutional databases and systems
Uses spreadsheets and database software to analyze charge, cost, and collection data for patients participating in clinical trials
Prepares monthly statements and invoices for review and payment by the Principal Investigator for clinical research charges per study
Maintains spreadsheets of study accounts and write-offs sent to Financial Services and Patient Accounting for institutional processing and tracking
Maintains and updates clinical trials in the Epic system (online medical record system)
Processes and reviews clinical research charges in Epic for both technical and professional charges
Accesses institutional charge masters to provide pricing for procedures using both SIMS and CPT codes
Accesses BRAIN to ensure the accuracy of IRB protocol information and verify approval
Accesses the Clinical Trials Management System (CTMS) to ensure appropriate billing modifiers are used on billing grids
Conducts clinical research billing audits of study records upon request or as needed.
Participates in cross-training with other staff on the Research Billing Compliance team
Learns FDA device regulations, CMS billing guidelines, and appropriate billing rules for various populations
Conducts and completes special projects as assigned and defined by the Assistant Director and/or Director within established timelines determined at project inception and by project participants and circumstances
Develops budgets for sponsors