Ensure compliant research billing practice for assigned department(s) at University Hospitals Cleveland Medical Center and UHHS, including comprehensive knowledge & application of CMS regulations, maintaining UH billing standards, and record maintenance including accurate grant reporting. (45%)Demonstrate efficient task performance, high level of organization and the maintenance of accurate administrative records, including database entries and reporting, to meet management goals. (15%)Through e... more details
Essential Functions
Ensure compliant research billing practice for assigned department(s) at University Hospitals Cleveland Medical Center and UHHS, including comprehensive knowledge & application of CMS regulations, maintaining UH billing standards, and record maintenance including accurate grant reporting. (45%)
Demonstrate efficient task performance, high level of organization and the maintenance of accurate administrative records, including database entries and reporting, to meet management goals. (15%)
Through effective communication, provides guidance to colleagues and assists department research personnel in research patient billing matters. (10%)
Track One: CA Focus
• Develop patient care clinical project budgets which meet compliance and fiscal standards, utilizing thorough knowledge of coverage analysis and budgeting principles. Assist in negotiation of budget with Sponsor. (30%)
or
Track Two: Claim Management Focus
• Partner with revenue cycle to assist with resolving research claim denials, manage third party insurance issues, and independently process complex research claims according to CMS or private payor rules to ensure maximum payment recovery on outstanding billing. (30%)
Required For All Jobs
Performs other duties as assigned.
Complies with all policies and standards.
For specific duties and responsibilities, refer to documentation provided by the department during orientation.
Must abide by all requirements to safely and securely maintain Protected Health Information (PHI) for our patients. Annual training, the UH Code of Conduct and UH policies and procedures are in place to address appropriate use of PHI in the workplace.
Qualifications Education
Bachelor's Degree in finance, healthcare or related field (management, nursing, biology) Required
Work Experience
3 years demonstrated success with research administration in a health-care environment Required or
1 years demonstrated success in research patient care billing to include accurate charge segregation according to Medicare coverage regulations. Required
Knowledge, Skills, & Abilities
Must have in-depth knowledge of research financial process. Required
Essential skills include excellent organizational, communication, and trouble-shooting skills. Required
Strong analytical skills are needed to assess coverage analysis, interpret and reconcile research charges, and assure accurate grant reporting. Required
Strong communication skills are for mentoring junior colleagues. Required
Proficiency and technical skills with MS Office. Required
Prefer proficiency and technical skills with OnCore, Oracle, Velos and Soarian applications. Required
Knowledge of federal and state laws and regulations governing research billing and grant management Required
Knowledge of CMS and affiliate billing standards to ensure accurate processing of complex claims involving Radiation Therapy, Chemotherapy and Immunotherapy. Required
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