The MetroHealth System - Cleveland, OH

posted about 1 month ago

Full-time
Cleveland, OH
Ambulatory Health Care Services

About the position

The Clinical Research Charge Review Analyst at MetroHealth Medical Center is responsible for ensuring that charges related to grants and clinical trials are accurately billed for both physician and hospital services. This role involves working on reports to reduce Discharge Not Billed (DNB) accounts, communicating trends to minimize customer service issues, and making necessary corrections in the electronic medical record system. The analyst prepares reconciliation reports and verifies charge discrepancies with research study staff, while upholding the organization's mission and customer service standards.

Responsibilities

  • Ensure appropriate billing of charges associated with grants and clinical trials for physician and hospital services.
  • Work on reports and work queues to decrease Discharge Not Billed (DNB) accounts.
  • Assist in communicating trends to reduce customer service issues.
  • Make corrections within the electronic medical record (EMR) system according to coverage analysis and final study budget.
  • Prepare reconciliation reports in REDCap.
  • Independently verify and document charge discrepancies with research study staff as needed.
  • Identify, review, and verify invoiceable items charged in EMR and send to research business analyst for invoicing to study sponsor.

Requirements

  • 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 healthcare issues affecting billing and reimbursement.
  • Ability to read and comprehend complex materials.
  • Detail-oriented with the 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 with the 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, including Microsoft Office Suite.

Nice-to-haves

  • 1 year direct experience completing coverage analysis.
  • Experience with Epic EMR and its research module.
  • Clinical research experience.
  • Preferred Epic and REDCap experience.
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