Research Billing Quality Review Analyst - Hybrid

Acord Solutions Group - San Diego, CA

Full-time

San Diego, CA

Professional, Scientific, and Technical Services

About the position

The Research Billing Quality Review Analyst plays a crucial role in overseeing audits of research-related billing processes within UC San Diego Health's Revenue Cycle department. This position ensures compliance with Medicare, Medi-Cal, and commercial insurance regulations while acting as a liaison among physicians, researchers, and internal stakeholders. The Analyst is responsible for conducting audits, providing training, and developing strategies to optimize research billing workflows, thereby supporting the organization's mission to deliver outstanding patient care.

Responsibilities

• Collaborate with research clinical staff and various departments to maintain compliance with clinical trial billing workflows.
• Provide guidance on clinical trial regulations and best practices to internal and external parties.
• Address internal billing challenges and support cross-departmental alignment in meetings.
• Conduct annual billing training for research staff and training for new hires as needed.
• Synthesize regulations and industry publications to assist in developing training materials and guidance documents.
• Conduct regular, ad hoc, and for-cause audits to ensure compliance with laws and internal policies.
• Provide detailed reports of findings and contribute to corrective and preventative action plans.

Requirements

• Seven (7) years of related research billing audit experience, or a Bachelor's degree in a related area plus three (3) years of related experience.
• Thorough knowledge of healthcare revenue cycle practices, including billing, collections, and third-party reimbursements.
• Understanding of revenue cycle measurement tools and analytics.
• Detail-oriented with strong time management and organizational skills.
• Strong skills in report development and dashboard design specific to healthcare revenue cycle management.
• Proficient in common database, spreadsheet, and presentation software.
• Strong communication skills to convey complex clinical finance information clearly.
• Ability to prepare informative reports and presentations.
• Strong analytical and problem-solving skills to evaluate workflows and propose solutions.
• Strong interpersonal skills for effective collaboration on complex projects.

Benefits

• Hybrid work schedule (onsite and remote)
• Challenging career opportunities in a fast-paced environment
• Commitment to quality and continuous improvement