Clinical Research Charge Review Analyst - MetroHealth
Cleveland, OH
About the Job
Location: METROHEALTH MEDICAL CENTER
Biweekly Hours: 80.00
Shift: 8-4:30
The MetroHealth System is redefining health care by going beyond medical treatment to improve the foundations of community health and well-being: affordable housing, a cleaner environment, economic opportunity and access to fresh food, convenient transportation, legal help and other services. The system strives to become as good at preventing disease as it is at treating it. Founded in 1837, Cuyahoga County's safety-net health system operates four hospitals, four emergency departments and more than 20 health centers.
Summary:
Ensures that charges associated with grants and clinical trials are billed appropriately for both physician and hospital services, including working on reports and work queues to decrease Discharge Not Billed (DNB) accounts and assisting in communicating trends to reduce customer service issues. Makes corrections within epic for charges according to coverage analysis (CA) and final study budget. Prepares reconciliation reports (in REDCap). Independently verifies, and documents charge discrepancies with research study staff as needed. Identifies, reviews, and verifies invoiceable items charged in epic are sent to research business analyst (RBA) for invoicing to study sponsor (via REDCap). Upholds the mission, vision, values, and customer service standards of The MetroHealth System.
Qualifications:
Bachelor's degree in a related field and 4 years of relevant experience in research billing, compliance, and/or direct involvement with sponsored clinical trials. In lieu of degree, 6 years of relevant experience in research billing, compliance, and/or direct involvement with sponsored clinical trials. Experience with electronic medical record (EMR) systems. Experience within a healthcare provider organization. Knowledge of Health Care Financing Administration (HFCA) billing practices, and health care issues effecting billing and reimbursement. Maintain a high level of professionalism and provides clear and consistent information about the billing compliance process. Ability to read and comprehend complex materials. Detail oriented with ability to independently research source materials and develop reasonable approaches to issues as they arise. Excellent verbal and written communication skills. Good organization and problem-solving skills and ability to work independently. Understanding of human subjects' research and good clinical practice. Familiarity with medical terminology. Ability to problem solve, multi-task, work with interruptions, and be an effective listener. Proficiency with personal computers and various software applications, to include Microsoft Office Suite and the ability to do sophisticated internet searches. Ability to interact effectively with a wide range of cultural, ethnic, racial, and socioeconomic backgrounds. Preferred: 1 year direct experience completing coverage analysis. Experience with Epic EMR and its research module. Clinical research experience. Preferred Epic and REDCap experience Physical Demands: May sit, stand, stoop, bend, and ambulate intermittently during the day. May need to sit or stand for extended periods. See in the normal visual range with or without correction. Hear in the normal audio range with or without correction. Finger dexterity to operate office equipment required. May need to lift, up to twenty-five (25) pounds on occasion. Ability to communicate in face-to-face, phone, email, and other communications. Ability to travel to MHS satellite sites if needed. Ability to see computer monitor and departmental documents.
Biweekly Hours: 80.00
Shift: 8-4:30
The MetroHealth System is redefining health care by going beyond medical treatment to improve the foundations of community health and well-being: affordable housing, a cleaner environment, economic opportunity and access to fresh food, convenient transportation, legal help and other services. The system strives to become as good at preventing disease as it is at treating it. Founded in 1837, Cuyahoga County's safety-net health system operates four hospitals, four emergency departments and more than 20 health centers.
Summary:
Ensures that charges associated with grants and clinical trials are billed appropriately for both physician and hospital services, including working on reports and work queues to decrease Discharge Not Billed (DNB) accounts and assisting in communicating trends to reduce customer service issues. Makes corrections within epic for charges according to coverage analysis (CA) and final study budget. Prepares reconciliation reports (in REDCap). Independently verifies, and documents charge discrepancies with research study staff as needed. Identifies, reviews, and verifies invoiceable items charged in epic are sent to research business analyst (RBA) for invoicing to study sponsor (via REDCap). Upholds the mission, vision, values, and customer service standards of The MetroHealth System.
Qualifications:
Bachelor's degree in a related field and 4 years of relevant experience in research billing, compliance, and/or direct involvement with sponsored clinical trials. In lieu of degree, 6 years of relevant experience in research billing, compliance, and/or direct involvement with sponsored clinical trials. Experience with electronic medical record (EMR) systems. Experience within a healthcare provider organization. Knowledge of Health Care Financing Administration (HFCA) billing practices, and health care issues effecting billing and reimbursement. Maintain a high level of professionalism and provides clear and consistent information about the billing compliance process. Ability to read and comprehend complex materials. Detail oriented with ability to independently research source materials and develop reasonable approaches to issues as they arise. Excellent verbal and written communication skills. Good organization and problem-solving skills and ability to work independently. Understanding of human subjects' research and good clinical practice. Familiarity with medical terminology. Ability to problem solve, multi-task, work with interruptions, and be an effective listener. Proficiency with personal computers and various software applications, to include Microsoft Office Suite and the ability to do sophisticated internet searches. Ability to interact effectively with a wide range of cultural, ethnic, racial, and socioeconomic backgrounds. Preferred: 1 year direct experience completing coverage analysis. Experience with Epic EMR and its research module. Clinical research experience. Preferred Epic and REDCap experience Physical Demands: May sit, stand, stoop, bend, and ambulate intermittently during the day. May need to sit or stand for extended periods. See in the normal visual range with or without correction. Hear in the normal audio range with or without correction. Finger dexterity to operate office equipment required. May need to lift, up to twenty-five (25) pounds on occasion. Ability to communicate in face-to-face, phone, email, and other communications. Ability to travel to MHS satellite sites if needed. Ability to see computer monitor and departmental documents.
Source : MetroHealth