Clinical Research Billing Specialist

2 months ago

Temple Terrace, United States Moffitt Cancer Center Full time
Position Highlights:The specialist will utilize the OnCore Clinical Trial Management System (CTMS) financial functionality to track billable items and be responsible for following up with study teams if billing information is missing or improperly captured. Review study activity for billable services or visits and invoice sponsors for this activity. Responsible for submitting claims to all insurance companies. Investigate and resolve insurance company denials/inquiries concerning services, billing, or fees/charges. Investigate duplicate/overpayments. Notify/refund the appropriate payer. Responsible for gathering charge information, coding, distributing appropriate information, and sponsoring claim management

The Ideal Candidate Will Have:
  • Bachelor’s Degree in Business, Finance, Accounting, similar educational program, or equivalent

Responsibilities:Tracks new Clinical Trials patients through appropriate system, placing selected accounts on hold for review
  • Reviews active research patient accounts for business office requirements, verifying conformity with established protocol budget and study-required patient care services prior to patient/insurance billing.
Audits Clinical Trials patient accounts, based on notification from the clinical trial team
  • Previously submitted to patient/insurance verifying correct billing as it relates to study budget, identifying possible errors.
Works closely with Moffitt Cancer Center business/insurance billing to assist with unusual and complex billing and reimbursement issues associated with research patient’s accounts
  • Assists in the development of research patient financial services policies and procedures.
  • Reviews, researches and resolves complex research patient billing issues.
Problem solves and makes suggestions to Director of Clinical Research Revenue Integrity:
  • Applying appropriate and varying processing procedures in determining research charges which need to be written off.
  • Assists in the development, implementation and enhancement of specific projects related to research financial patient issues by defining overall project goals, expectations of customers, tasks and activities required to achieve goals.
Participates in development of reporting and tracking requirements:
  • Identifying Clinical Trial patients billing discrepancies; assists in development of guidelines for responding to specific inquiries from patients (referred by Business Office) relating to billing issues, and development of appropriate documentation
  • Work closely with all Moffitt Cancer Center and Moffitt Medical Group (MMG) physicians and clinic staff. Ensures that all charges are captured and billing the E & M outpatient and inpatient services for physician research.

Credentials and Qualifications:
  • Associate’s Degree in Business, Finance, Accounting, similar educational program, or equivalent experience
  • Minimum of three (3) years’ experience in clinical research hospital/physician billing, medical audit or case management, patient financial services and/or revenue cycle billing, or clinical trails coordination 
    • In lieu of Associates degree, a High School diploma/GED plus five (5) years' experience in clinical research hospital billing/physician billing, medical audit or case management, patient financial service and/or revenue cycle billing, or clinical trails coordination is acceptable. Additionally, a Bachelors Degree plus one (1) year experience in clinical research hospital billing/physician billing, medical audit or case management, patient financial services and/or revenue cycle billing, or clinical trails coordination is acceptable.

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