The University of Texas Medical Branch
Clinical Trials Coverage Analyst (Research Administration - Galveston)
The University of Texas Medical Branch, Galveston, Texas, United States, 77554
Overview
Clinical Trials Coverage Analyst (Research Administration - Galveston) at The University of Texas Medical Branch (UTMB Health). Minimum Qualifications
Bachelor’s degree or equivalent, five years of related experience. Education & Experience
Minimum Qualifications: Bachelor’s degree or equivalent, five years of related experience. Preferred Qualifications
Medical coding Job Summary
Provides centralized administrative review of clinical trial agreements, study protocols, informed consent documents, and budgets to ensure Principal Investigators and other billing entities comply with federal and state regulations for clinical research billing. Essential Job Functions
Determine whether proposed clinical trials qualify as defined in all relevant national coverage decisions. Act as a resource and assist Principal Investigators, study coordinators, and budget analysts in determining that all costs for clinical studies are included in the study budget and are appropriate and/or accurate. With input from the principal investigators and study coordinators, determine the proper allocation of items and services between routine and research costs, and set up methods to bill accordingly. This includes ensuring budget worksheets identify appropriate billing parties, reviewing financial agreements with UTMB contracts specialists, and ensuring financial consistency between research agreements and study protocols. Ensure that relevant sections of the informed consent document conform to CMS billing rules. Assist in mandatory training courses for faculty and personnel involved in clinical research when necessary. Coordinate the development of Standard Operating Procedures (SOPs) for all entities involved with clinical research billing. Assist in the development of monitoring plans for billing-related activities. Generate billing grids with applicable CPT and/or other codes in the Institution’s Clinical Trial Management System. Remain knowledgeable and up to date with current FDA and Medicare guidelines for clinical trial billing. Maintain a complete portfolio of accounts receivable throughout the revenue cycle, including charge review, account work queues, claim edits, and claim submission. Review charges in Epic and Epic-generated reports to identify standard-of-care, research-related, or indeterminate services. Follow federal and state regulations to ensure compliance standards are met. Review research patient accounts to ensure research charges are routed appropriately. Communicate with Revenue Cycle teams, payors, and others to resolve account discrepancies or errors. Participate in meetings, as needed, to address potential payor concerns. Other duties as assigned. Adhere to internal controls and reporting structure. Perform related duties as required. Knowledge/Skills/Abilities
Working knowledge of Epic and OnCore systems Communication skills Problem-solving skills Critical Thinking Licenses, Registrations or Certifications
Required: NA Preferred: NA Supervision
NA Working Environment/Equipment
The standard office environment at UTMB’s main campus is Galveston. Salary Range
Commensurate with experience Equal Employment Opportunity
UTMB Health strives to provide equal opportunity employment without regard to race, color, religion, age, national origin, sex, gender, sexual orientation, gender identity/expression, genetic information, disability, veteran status, or any other basis protected by institutional policy or by federal, state or local laws unless such distinction is required by law. As a Federal Contractor, UTMB Health takes affirmative action to hire and advance protected veterans and individuals with disabilities. Job Details
Location: United States-Texas-Galveston; 0342 - Research Building 6 Organization: UTMB Health Job Type: Research Academic & Clinical; Regular; Shift: Standard; Employee Status: Non-Manager; Job Level: Day Shift
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Clinical Trials Coverage Analyst (Research Administration - Galveston) at The University of Texas Medical Branch (UTMB Health). Minimum Qualifications
Bachelor’s degree or equivalent, five years of related experience. Education & Experience
Minimum Qualifications: Bachelor’s degree or equivalent, five years of related experience. Preferred Qualifications
Medical coding Job Summary
Provides centralized administrative review of clinical trial agreements, study protocols, informed consent documents, and budgets to ensure Principal Investigators and other billing entities comply with federal and state regulations for clinical research billing. Essential Job Functions
Determine whether proposed clinical trials qualify as defined in all relevant national coverage decisions. Act as a resource and assist Principal Investigators, study coordinators, and budget analysts in determining that all costs for clinical studies are included in the study budget and are appropriate and/or accurate. With input from the principal investigators and study coordinators, determine the proper allocation of items and services between routine and research costs, and set up methods to bill accordingly. This includes ensuring budget worksheets identify appropriate billing parties, reviewing financial agreements with UTMB contracts specialists, and ensuring financial consistency between research agreements and study protocols. Ensure that relevant sections of the informed consent document conform to CMS billing rules. Assist in mandatory training courses for faculty and personnel involved in clinical research when necessary. Coordinate the development of Standard Operating Procedures (SOPs) for all entities involved with clinical research billing. Assist in the development of monitoring plans for billing-related activities. Generate billing grids with applicable CPT and/or other codes in the Institution’s Clinical Trial Management System. Remain knowledgeable and up to date with current FDA and Medicare guidelines for clinical trial billing. Maintain a complete portfolio of accounts receivable throughout the revenue cycle, including charge review, account work queues, claim edits, and claim submission. Review charges in Epic and Epic-generated reports to identify standard-of-care, research-related, or indeterminate services. Follow federal and state regulations to ensure compliance standards are met. Review research patient accounts to ensure research charges are routed appropriately. Communicate with Revenue Cycle teams, payors, and others to resolve account discrepancies or errors. Participate in meetings, as needed, to address potential payor concerns. Other duties as assigned. Adhere to internal controls and reporting structure. Perform related duties as required. Knowledge/Skills/Abilities
Working knowledge of Epic and OnCore systems Communication skills Problem-solving skills Critical Thinking Licenses, Registrations or Certifications
Required: NA Preferred: NA Supervision
NA Working Environment/Equipment
The standard office environment at UTMB’s main campus is Galveston. Salary Range
Commensurate with experience Equal Employment Opportunity
UTMB Health strives to provide equal opportunity employment without regard to race, color, religion, age, national origin, sex, gender, sexual orientation, gender identity/expression, genetic information, disability, veteran status, or any other basis protected by institutional policy or by federal, state or local laws unless such distinction is required by law. As a Federal Contractor, UTMB Health takes affirmative action to hire and advance protected veterans and individuals with disabilities. Job Details
Location: United States-Texas-Galveston; 0342 - Research Building 6 Organization: UTMB Health Job Type: Research Academic & Clinical; Regular; Shift: Standard; Employee Status: Non-Manager; Job Level: Day Shift
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