Research Finance Specialist II

3 weeks ago

Chardon, United States University Hospitals Full time
Essential Functions
  • Ensure compliant research billing practice for assigned department(s) at University Hospitals Cleveland Medical Center and UHHS, including comprehensive knowledge & application of CMS regulations, maintaining UH billing standards, and record maintenance including accurate grant reporting. (45%)
  • Demonstrate efficient task performance, high level of organization and the maintenance of accurate administrative records, including database entries and reporting, to meet management goals. (15%)
  • Through effective communication, provides guidance to colleagues and assists department research personnel in research patient billing matters. (10%)
  • Track One: CA Focus

    • Develop patient care clinical project budgets which meet compliance and fiscal standards, utilizing thorough knowledge of coverage analysis and budgeting principles. Assist in negotiation of budget with Sponsor. (30%)

    or

    Track Two: Claim Management Focus

    • Partner with revenue cycle to assist with resolving research claim denials, manage third party insurance issues, and independently process complex research claims according to CMS or private payor rules to ensure maximum payment recovery on outstanding billing. (30%)

Required For All Jobs
  • Performs other duties as assigned.
  • Complies with all policies and standards.
  • For specific duties and responsibilities, refer to documentation provided by the department during orientation.
  • Must abide by all requirements to safely and securely maintain Protected Health Information (PHI) for our patients. Annual training, the UH Code of Conduct and UH policies and procedures are in place to address appropriate use of PHI in the workplace.


Qualifications:
Qualifications Education
  • Bachelor's Degree in finance, healthcare or related field (management, nursing, biology) Required
Work Experience
  • 3+ years demonstrated success with research administration in a health-care environment Required or
  • 1+ years demonstrated success in research patient care billing to include accurate charge segregation according to Medicare coverage regulations. Required
Knowledge, Skills, & Abilities
  • Must have in-depth knowledge of research financial process. Required
  • Essential skills include excellent organizational, communication, and trouble-shooting skills. Required
  • Strong analytical skills are needed to assess coverage analysis, interpret and reconcile research charges, and assure accurate grant reporting. Required
  • Strong communication skills are for mentoring junior colleagues. Required
  • Proficiency and technical skills with MS Office. Required
  • Prefer proficiency and technical skills with OnCore, Oracle, Velos and Soarian applications. Required
  • Knowledge of federal and state laws and regulations governing research billing and grant management Required
  • Knowledge of CMS and affiliate billing standards to ensure accurate processing of complex claims involving Radiation Therapy, Chemotherapy and Immunotherapy. Required
Physical Demands
  • Standing Occasionally
  • Walking Occasionally
  • Sitting Constantly
  • Lifting Rarely 20 lbs
  • Carrying Rarely 20 lbs
  • Pushing Rarely 20 lbs
  • Pulling Rarely 20 lbs
  • Climbing Rarely 20 lbs
  • Balancing Rarely
  • Stooping Rarely
  • Kneeling Rarely
  • Crouching Rarely
  • Crawling Rarely
  • Reaching Rarely
  • Handling Occasionally
  • Grasping Occasionally
  • Feeling Rarely
  • Talking Constantly
  • Hearing Constantly
  • Repetitive Motions Frequently
  • Eye/Hand/Foot Coordination Frequently

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