Research Billing Compliance Specialist
3 weeks ago
Overview
Our team members are the heart of what makes us better.
At Hackensack Meridian Health we help our patients live better, healthier lives - and we help one another to succeed. With a culture rooted in connection and collaboration, our employees are team members. Here, competitive benefits are just the beginning. It's also about how we support one another and how we show up for our community.
Together, we keep getting better - advancing our mission to transform healthcare and serve as a leader of positive change.
The Research Billing Compliance Specialist reviews, adjusts, and reports on clinical trials charges and claims representing research while working closely with Patient Financial Services (PFS), Registration and Ancillary hospital departments and third parties. The Research Billing Compliance Specialist is responsible for ensuring research charges are posted in accordance with Medicare's Clinical Trial Policy, federal regulations and pharmaceutical/third party contracts. The Research Billing Compliance Specialist also assists in the oversight of the day-to-day research finance operations.
Responsibilities
A day in the life of a Research Billing Compliance Specialist with Hackensack Meridian Health includes:
- Coordinate with research clinical staff, PFS, registration and third parties to ensure adherence to clinical trial billing workflows. a. Provide guidance and serve as a resource for clinical trial regulations and best practices to internal and applicable third parties.
- Review/report/transfer posted patient account charges in hospital billing system: a. Verify posted charges are correctly billed to the patient's insurer vs. research study on a daily basis by reviewing the DSA forms, clinical trial budget/contracts and hospital billing system.
- Prepare monthly reports capturing the accounts payable to the hospital for patient accounts and to third party vendors. a. Tracks and troubleshoots charge posting errors.
- Coordinate with Billing Specialist to identify invoiceable charges.
- Maintains DSA forms and documentation associated with clinical cancer research patient accounts.
- Resolves outstanding patient bills/disputes with the Finance department.
- Resolves patient bills/disputes with research subjects/staff as part of service recovery.
- Assists with the preparation of reports request by the Finance department.
- Troubleshoots internal department billing processes. 9. Attends finance meetings and assists other departments with global functioning details.
- Conducts annual billing training for research staff and as-needed basis for new hire employees
- Cross coverage with Research Billing Specialist: a. Assists with hotel, travel and subject stipend processes for research patients. b. Assists with tracking of department financials including invoice and reconciliation processes.
- Maintains strong lines of communication with ancillary departments and third party vendors.
- Provides other duties as assigned.
- Works on special projects for Clinical Cancer Research department as assigned by leadership.
- Adheres to standards identified in the Medical Center's Organizational Competencies.
Qualifications
Education, Knowledge, Skills and Abilities Required:
- Bachelor's degree in Accounting, Science, Healthcare or equivalent experience
- Minimum of 2 years of experience of CPT coding/patient financial services.
- Advanced Microsoft Office skills specifically in Excel.
- Ability to analyze complex situations and identify solutions.
- Ability to work effectively as a member of a team.
- Effective written and verbal communication skills; excellent interpersonal skills.
- Must be able to use basic office equipment.
Education, Knowledge, Skills and Abilities Preferred:
- Experience with oncology and/or research.
- Experience with billing and collection processes.
Licenses and Certifications Preferred:
- SOCRA CCRP certification or equivalent certification.
If you feel that the above description speaks directly to your strengths and capabilities, then please apply today
Our Network
Hackensack Meridian Health (HMH) is a Mandatory Influenza Vaccination Facility
As a courtesy to assist you in your job search, we would like to send your resume to other areas of our Hackensack Meridian Health network who may have current openings that fit your skills and experience.
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