Clinical Research Billing Specialist

Position Highlights The specialist will utilize the OnCore Clinical Trial Management System (CTMS) financial functionality to track billable items and be responsible for following up with study teams if billing information is missing or improperly captured. Review study activity for billable services or visits and invoice sponsors for this activity. Responsible for submitting claims to all insurance companies. Investigate and resolve insurance company denials/inquiries concerning services, billing, or fees/charges. Investigate duplicate/overpayments. Notify/refund the appropriate payer. Responsible for gathering charge information, coding, distributing appropriate information, and sponsoring claim management. The Ideal Candidate Will Have Bachelor’s Degree in Business, Finance, Accounting, similar educational program, or equivalent. Responsibilities Tracks new Clinical Trials patients through appropriate system, placing selected accounts on hold for review. Reviews active research patient accounts for business office requirements, verifying conformity with established protocol budget and study-required patient care services prior to patient/insurance billing. Audits Clinical Trials patient accounts, based on notification from the clinical trial team. Works closely with Moffitt Cancer Center business/insurance billing to assist with unusual and complex billing and reimbursement issues associated with research patient’s accounts. Assists in the development of research patient financial services policies and procedures. Reviews, researches and resolves complex research patient billing issues. Problem solves and makes suggestions to Director of Clinical Research Revenue Integrity. Participates in development of reporting and tracking requirements. Identifying Clinical Trial patients billing discrepancies; assists in development of guidelines for responding to specific inquiries from patients (referred by Business Office) relating to billing issues, and development of appropriate documentation. Work closely with all Moffitt Cancer Center and Moffitt Medical Group (MMG) physicians and clinic staff. Ensures that all charges are captured and billing the E & M outpatient and inpatient services for physician research. Credentials And Qualifications Associate’s Degree in Business, Finance, Accounting, similar educational program, or equivalent experience. Minimum of three (3) years’ experience in clinical research hospital/physician billing, medical audit or case management, patient financial services and/or revenue cycle billing, or clinical trials coordination. In lieu of Associates degree, a High School diploma/GED plus five (5) years' experience in clinical research hospital billing/physician billing, medical audit or case management, patient financial service and/or revenue cycle billing, or clinical trials coordination is acceptable. Additionally, a Bachelors Degree plus one (1) year experience in clinical research hospital billing/physician billing, medical audit or case management, patient financial services and/or revenue cycle billing, or clinical trials coordination is acceptable. Seniority level:

Mid-Senior level Employment type:

Full-time Job function:

Finance Industries:

Hospitals and Health Care

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