Research Compliance (TEMP)

University Of Michigan - Ann Arbor, MI

Full-time - Entry Level

Remote - Ann Arbor, MI

Educational Services

About the position

The Research Compliance Clerk B position at Michigan Medicine is responsible for ensuring the timely and accurate flow of clinical trial billing and reimbursement operations. Reporting to the Manager of Revenue Cycle Research Compliance, this role involves researching and analyzing research-related charges, updating procedures for discrepancies, and collaborating with departmental study staff to enhance operational efficiency in clinical research billing.

Responsibilities

• Identifying potential clinical research charges through MiChart Work Queues and adjudicating appropriately.
• Identifying potential clinical research charges not specifically defined in research protocols.
• Researching and analyzing charges by reading physician medical notes and reviewing research protocols, informed consent forms, and other associated documents.
• Making determinations on whether each charge is research-related and how it should be billed.
• Overseeing and resolving all clinical research charge activities for all clinical departments and/or sections.
• Providing continuous comprehensive analyses of findings encompassing claim submission and status, payment history, rejection analysis, and unpaid clinical research claims.
• Identifying and advising on operational improvements to enhance efficiency of clean-claim submissions for prompt payment and overall reimbursement of clinical research services.
• Working closely with Calendar Review and Analysis Office (CRAO) to enhance workflows and maintain support to study teams.
• Utilizing and promoting LEAN in Daily Work through root cause analysis and capturing metrics.
• Functioning as a resource and educator for clinical department physicians and research staff on clinical research billing, reimbursement, and coding issues.
• Researching policies of payers and communicating changes as appropriate.
• Maintaining regular interactions with Third Party Payers to ensure compliance with regulations, including claim submission and coding accuracy.
• Performing quality assurance processing and assessing risk for non-compliance with internal audit findings.

Requirements

• Knowledge of legal, regulatory and policy compliance issues related to medical coding and documentation and billing procedures.
• Ability to analyze, problem-solve, and work independently.
• Strong communication and interpersonal skills.

Nice-to-haves

• Strong working knowledge and experience with clinical trial regulatory documents such as protocols and informed consents and Clinical Trial Agreements (CTA).

Benefits

• Mobile/Remote work options available.
• Full-time position with potential for hybrid work mode.