RESEARCH BILLING COMPLIANCE SPECIALIST in Indianapolis, IN at Eskenazi Health

Date Posted: 1/21/2020

Job Snapshot

Job Description



Organization: HHC



Division:Eskenazi Health  



Sub-Division: Hospital  



Req ID:  2812 



Schedule: Full Time 



Shift: Days 

Eskenazi Health serves as the public hospital division of the Health & Hospital Corporation of Marion County. Physicians provide a comprehensive range of primary and specialty care services at the 315-bed hospital and outpatient facilities both on and off of the Eskenazi Health downtown campus as well as at 10 Eskenazi Health Center sites located throughout Indianapolis.



JOB SUMMARY:  

This position is responsible for supervising, coordinating and administering research finance and billing compliance for all studies throughout Eskenazi Health. Reporting to the Clinical Research manager, this person will ensure compliance with regulatory policies and procedures related to billing compliance. The Specialist is expected to ensure accurate billing for patients enrolled in clinical trials in accordance with federal regulations to reduce both institutional and individual provider legal and financial risks. The Specialist will work collaboratively with all process owners to educate and ensure documentation which supports coding, charging, and billing for all services provided to an individual patient enrolled in research or clinical trials.



ESSENTIAL JOB FUNCTIONS:

  • Leverage patient tracking system to ensure all invoices are billed appropriately and track every protocol subject’s bills.
  • Oversees the conduct of Medicare Coverage Analysis or reviews the Coverage Analysis from IU on all clinical research projects to determine appropriate payer source for clinical trial services applying coverage rules to develop budget justification in the trial budget.
  • Develop and oversee protocols and procedures for charging, billing and collection of payments for research studies across Eskenazi Health.
  • Assist with pricing and discounting for research purposes and clarify budgets identifying with the study protocol, study calendar and other study related documents in accordance with clinical trials budgeting policy.
  • Assist clinical research staff in reviewing and identifying charges that are trial related
  • Assist in the analysis of processes and recommend changes and/or modifications to meet compliance and customer service goals.
  • Collaborates with the Clinical Research Manager, Revenue Cycle, and Compliance on complex issues to provide physicians and other billing staff with complete and accurate billing compliance guidance.
  • Continuing education is constantly required to keep updated on new rules, regulations and revisions, as set forth by the Center for Medicare and Medicaid Services (CMS) and other entities regarding billing compliance.
  • Create a Research Billing Compliance audit plan
  • Provides technical assistance for the auditing processes, standards and quality of the audit work product generated by compliance audit team.
  • Establishes and maintains a professional working relationship with Revenue Cycle, Research, medical staff members, Legal, Compliance, and external participants involved with the process to ensure accurate documentation, coding, charging and billing for all services provided related to research or clinical trial billing.



JOB REQUIREMENTS:  

  • Bachelor's degree in business, finance, hospital/ health care administration or related field. Master’s preferred.
  • Three years of recent work experience in finance, accounting, or clinical research compliance and billing.
  • Required to have basic working knowledge of medical terminology, ICD-10 CPT, HCPCS, DRG, APC, FDA, Office of Human Research Protection, revenue and charge master codes.

Accredited by The Joint Commission and named one of the nation’s 150 best places to work by Becker’s Hospital Review for four consecutive years and Forbes list of best places to work for women, and Forbes list of America’s best midsize employers’ Eskenazi Health’s programs have received national recognition while also offering new health care opportunities to the local community. As the sponsoring hospital for Indianapolis Emergency Medical Services, the city’s primary EMS provider, Eskenazi Health is also home to the first adult Level I trauma center in Indiana, the only verified adult burn center in Indiana, the first community mental health center in Indiana and the Eskenazi Health Center Primary Care – Center of Excellence in Women’s Health, just to name a few.

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