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Research Billing Analyst

BRONX, NY, US


Job Summary:

This position is responsible for reviewing charges for patients on clinical trials based on Medicare Coverage rules and the Clinical Trials contracts to ensure proper reimbursement and study billing requirements are met. Ensure performance metrics are at or above the standardized levels. The incumbent will drive and coordinate processes to secure maximum revenue from study fees through timely and accurate billing and collection. He/she sets clear and achievable goals and puts the necessary metrics in place to monitor and ensure progress.

 

Job Responsibilities:

  • Monitor billing designations and research clinical documentation, coding, and service charges to distinguish between research-related and non-research-related activities
  • Review charges linked to research for accurate billing and routing based on Coverage Analysis in a timely manner
  • Functions as a resource for coverage analyses to ensure compliant and accurate identification of services billable to third parties. May function as a resource for Coverage Analysis for Investigator Initiated Trials.
  • Collaborates with Revenue Cycle and Hospital/Profession Billing to ensure appropriate designation of procedures and standard of care or research and assist with their inquiries and Billing Compliance as needed.
  • Supports EPIC and Velos teams in creating system-wide interconnectedness of research finances and billing within the research enterprise.
  • Involved in developing strategy for maximizing financial opportunities in the conduct of research through accurately and timely charge review and accurate designation on research and hospital billing.
  • Perform special projects and miscellaneous duties as needed and requested.

 

Job Requirements:

  • Bachelor’s Degree Required
  • Knowledge of Epic, ICD-10 and/or CPT Codes and research billing highly desirable
  • Working knowledge of hospital charge capture flow, and charge description master Proficient working knowledge of Microsoft office required.
  • Proficient in Microsoft Excel computer skills including formula functions, sorting and charting preferred.
  • Strong knowledge of clinical processes, medical terminology, and the clinical research life cycle required. Working knowledge of Centers for Medicare and Medicaid Services clinical trial policy
  • Working knowledge of, medical billing and billing compliance Ability to prioritize multiple tasks and meet deadlines with minimal supervision
  • Strong analytical, verbal and written communication skills, and problem-solving skills; the ability to correctly decipher regulatory or procedural language
  • Ability to understand in-house developed systems and identify risks with, or gaps in, those systems

 

Department: Office of Clinical Trials Bargaining Unit: Non Union Campus: MOSES  Employment Status: Regular Full-Time Address: 111 East 210th Street, Bronx
Shift: Day Scheduled Hours: 8:30 AM-5 PM Req ID: 170202 

 

Montefiore is an equal employment opportunity employer. Montefiore will recruit, hire, train, transfer, promote, layoff and discharge associates in all job classifications without regard to their race, color, religion, creed, national origin, alienage or citizenship status, age, gender, actual or presumed disability, history of disability, sexual orientation, gender identity, gender expression, genetic predisposition or carrier status, pregnancy, military status, marital status, or partnership status, or any other characteristic protected by law. 

 

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Vision:
To be a premier academic medical center that transforms health and enriches lives.

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Define our philosophy of care, they shape our actions and motivate and inspire us to pursue excellence and achieve the goals we have set forth for the future. Our values include:

  • Humanity
  • Innovation
  • Teamwork
  • Diversity
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