The Project Manager - Clinical Research Revenue Cycle of the Office of Sponsored Programs and Research Finance (OSPRF) will implement clinical research billing best practices and provide exceptional support to internal and external clients of CHRISTUS Health System, CHRISTUS Institute for Advanced Clinical Care (CIIACC), partners and affiliates. The primary purpose of the Project Manager - Clinical Research Revenue Cycle is to analyze and resolve complex clinical research patient accounts. The Project Manager will utilize various systems (i.e. Epic, Meditech, manual billing processes) to correctly identify accounts with clinical research charges, and route these charges for payment according to the coverage analysis. Once research charges are identified and transferred to the appropriate account, the Project Manager will follow up with the Financial Analyst to ensure timely payment of research charges. In addition to reconciling patient accounts, the Project Manager - Clinical Research Revenue Cycle will complete pre-award tasks to include full study builds in the Clinical Trial Management System (CREDIT), developing and coding billing grids from the study builds, loading study budgets into the study builds, etc. Under the guidance of the Manager of the Office of Sponsored Programs & Research Finance, the Analyst will also develop best practices within the Office and serve as an established resource for clinical research billing and compliance for study teams within the CHRISTUS Health Research Enterprise.
This position is responsible for developing accurate coverage analyses in accordance with Medicare's Clinical Trial Policy (NCD 310.1) and assisting research staff within the clinical departments with the interpretation of related guidance and their effect on research billing processes
Work a large volume of bill hold accounts for both Professional and Hospital Billing within established productivity goals.
Reviews accounts and identifies charges billable either to insurance or to the clinical research study.
Ensures all necessary information is received to substantiate charges.
Identifies and resolves issues with the billing process.
Maintains clinical billing procedures and identifies process improvement initiatives.
Serves as a resource for research study teams related to clinical research billing.
Provides coding guidance to the Pre-Award team for coverage analysis and budgeting purposes.
Provides coding education to providers and other staff.
Complete coverage analysis, study builds in the Clinical Trial Management System, assist with budget preparation, etc.
Bachelor's degree in Finance, Business, Management or other related field required, Master's degree preferred.
Strong inpatient and outpatient coding.
Have working knowledge of research IDE billing process
Strong organization, communication, negotiation, and analytic skills required.
Extensive customer service interactions required.
Knowledge of research administration strongly preferred.
Must have the ability to work independently.
Must have the ability to meet deadlines.
3 years of revenue cycle coding preferred
1 year of clinical research experience
Knowledge of CPT and ICD-10 coding. (Oncology coding experience is a plus)
Knowledge of multiple Electronic Medical Record (EMR) systems including Epic, Meditech, Athena, Mosaic, Aria, OncoEMR, etc.
Ability to read, analyze, and interpret medical records and charge documents
CHRISTUS HEALTH is an international Catholic, faith-based, not-for-profit health system comprised of almost more than 600 services and facilities, including more than 60 hospitals and long-term care facilities, 350 clinics and outpatient centers, and dozens of other health ministries and ventures. CHRISTUS operates in 6 U.S. states, Colombia, Chile and 6 states in Mexico. To support our health care ministry, CHRISTUS Health employs approximately 45,000 Associates and has more than 15,000 physicians on medical staffs who provide care and support for patients. CHRISTUS Health is listed among the top ten largest Catholic health systems in the United States.