Research Billing Compl Anly - Research Administration - 004 at Texas Children's Hospital

Houston, Texas, United States -

Full Time

Start Date

Immediate

Expiry Date

03 Sep, 26

Salary

0.0

Posted On

05 Jun, 26

Experience

0 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Clinical Research Billing, Compliance Auditing, Epic System, Medical Coding, Financial Data Analysis, Budget Development, Clinical Trial Management, Regulatory Compliance, Pricing Quotes, Billing Grid Management

Industry

Hospitals and Health Care

Description

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. Think you’ve got what it takes? Job Duties & 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 Skills & Requirements Bachelor's Degree Business or Hospital Administration or a related field required 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 1 year Experience in research, billing, compliance, finance or Health Care Administration preferred Familiarity with clinical trial study design, coordination and/or management preferred Since 1954, Texas Children’s has been leading the charge in patient care, education and research to accelerate health care for children and women around the world. When you love what you do, it truly shows in the smiles of our patient families, employees and our numerous accolades such as being consistently ranked as the best children’s hospital in Texas, and among the top in the nation by U.S. News & World Report as well as recognition from Houston Business Journal as one of this city’s Best Places to Work for ten consecutive years. Texas Children’s comprehensive health care network includes our primary hospital in the Texas Medical Center with expertise in over 40 pediatric subspecialties; the Jan and Dan Duncan Neurological Research Institute (NRI); the Feigin Tower for pediatric research; Texas Children’s Pavilion for Women, a comprehensive obstetrics/gynecology facility focusing on high-risk births; Texas Children’s Hospital West Campus, a community hospital in suburban West Houston; Texas Children’s Hospital The Woodlands, the first hospital devoted to children’s care for communities north of Houston; and Texas Children’s Hospital North Austin, the new state-of-the-art facility providing world-class pediatric and maternal care to Austin and Central Texas families. We have also created Texas Children’s Health Plan, the nation’s first HMO focused on children; Texas Children’s Pediatrics, the largest pediatric primary care network in the country; Texas Children’s Urgent Care clinics that specialize in after-hours care tailored specifically for children; and a global health program that is channeling care to children and women all over the world. Texas Children’s Hospital is affiliated with Baylor College of Medicine, one of the largest, most diverse and successful pediatric programs in the nation. To join our community of 15,000+ dedicated team members, visit texaschildrenspeople.org [https://www.texaschildrenspeople.org/career/?job_id=414012] for career opportunities. Texas Children’s is proud to be an equal opportunity employer. All applicants and employees are considered and evaluated for positions at Texas Children's without regard to mental or physical disability, race, color, religion, gender, national origin, age, genetic information, military or veteran status, sexual orientation, gender identity, marital status or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.

Responsibilities

Responsible for reviewing and processing clinical research billing activities and billing grids to ensure accuracy and compliance. Collaborates with study teams and financial departments to prevent inappropriate billing of patients and third parties.