Facilitate accurate billing for patients enrolled in clinical trials in accordance with federal regulations to reduce both institutional and individual provider legal and financial risk. The position is integrated into the University of MN research processes and involves frequent interaction with internal and external stakeholders. The primary responsibilities are related to translating research protocol requirements and ensuring that charges associated with grants and clinical trials are billed appropriately for both physician and hospital services. The analysis of the research protocol includes adding Fairview charge codes and the creation and management of research billing accounts including research invoicing and collection activity. Additional responsibilities include research fee schedule maintenance, research coding functions, financial reporting, and general research revenue cycle process management. Also responsible for assisting in the creation and implementation of administrative and operational improvements.
Research billing account management
Establish billing accounts in Epic and QuickBooks
Diligently work research revenue cycle work queues in Epic including charge review, account review and application of research coding to decrease bill hold account
Translate review of UMN clinical trial management system accounts and apply to research billing work queues to meet federal research billing compliance standards
Resolve service discrepancies in a timely manner
Generate accurate monthly invoices to researchers
Ensure research payment application processes are timely
Manage research A/R and participate in collection activity
Assist in educating principal investigators-study teams regarding compliance with government regulations with special attention to CMS guidelines as they pertain to billing for patients enrolled in clinical trials
Consistently document standard work and disseminate to team
Assist in the analysis and audit of processes and recommend changes and/or modification to meet research billing compliance requirements
Revenue cycle reporting
Quarterly financial reports Epic and QuickBook activity
Provide monthly departmental research revenue cycle metrics
Generate monthly aging reports
Provide quarterly Write-off and Adjustments metrics
Provide Semi-annual ancillary department reports
Generate annual financial summary
Create and maintain research fee schedules.
Perform an annual review and update fee schedule
Translate protocol driven services into Fairview charge codes and update fee schedule timely
Provide research pricing information to internal and external customers
Research and collaboratively identify codes and pricing for new or unusual procedures and diagnoses
Facilitate communication of updates to internal and external stakeholders
Provide superior customer service
Assist in the analysis and audit of processes and recommend changes to meet customer service goals
Provide prompt replies to inquiries
Serve as an ambassador to clinical research teams, providing professional, courteous, and timely service
Serve as a resource to internal and external stakeholders
Organization Expectations, as applicable:
Demonstrates ability to provide care or service adjusting approaches to reflect developmental level and cultural differences of population served.
Partners with patient care giver in care/decision making.
Communicates in a respective manner.
Ensures a safe, secure environment.
Individualizes plan of care to meet patient needs.
Modifies clinical interventions based on population served.
Provides patient education based on as assessment of learning needs of patient/care giver.
Fulfills all organizational requirements.
Completes all required learning relevant to the role.
Complies with and maintains knowledge of all relevant laws, regulation, policies, procedures and standards.
Fosters a culture of improvement, efficiency and innovative thinking.
Performs other duties as assigned.
High School Diploma or equivalent is required, preferably supplemented by post-secondary courses in Accounting, Finance, Business Administration, Research Billing Compliance
Two years experience with revenue cycle activity in a healthcare setting.
Bachelors degree in Accounting, Finance, Business Administration, Health Information Coding, or related field.
Three or more years in healthcare billing, accounting, business administration or related research administration.
Credentialed as a Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT) or a Certified Coding Specialist (CCS).
Additional Requirements (must be obtained or completed within a period of time): Proficient in MS Office, Word, EXCEL, and electronic health record (EPIC)
Working knowledge of medical vocabulary and terminology principles with an ability to apply in clinical trials billing operations Ability to interpret federal regulations and research clinical trials billing compliance guidelines Ability to critically read and interpret research protocols Skill in computer systems, including Epic research module and revenue cycle workflows Proficiency in manipulating numbers Detail oriented and critical thinking skills Ability to examine documents for accuracy and completeness Customer service orientated and ability to work in a team setting Ability to prioritize work Ability to meet deadlines and maintain accuracy Ability to accurately interpret and manipulate data Demonstrated aptitude for numbers Detail oriented Knowledge of and experience with electronic spreadsheets, charts, and graphs Experience with Epic research module and revenue cycle dashboards and metrics Ability to meet deadlines and maintain accuracy Ability to utilize technical tools for analysis and reporting Communicate effectively with internal revenue cycle colleagues regarding hospital fee schedule Ability to interpret research protocols and critically apply knowledge to developing new research codes Communicate effectively with internal and external stakeholders to implement new fee schedule and codes Ability to meet timelines and maintain accuracy Ability to prioritize and manage fluctuations in workload Strong communication skills Able to provide clear and accurate instruction Good listening skills Strong knowledge base related to revenue cycle activity Enjoys a fast-paced environment
Together with the University of Minnesota and University of Minnesota Physicians we have created M Health Fairview. M Health Fairview is the newly expanded collaboration among the University of Minnesota, University of Minnesota Physicians, and Fairview Health Services. The healthcare system combines the best of academic and community medicine — expanding access to world-class, breakthrough care through our 10 hospitals and 60 clinics.
Fairview Health Services (fairview.org) is an award-winning, nonprofit health system providing exceptional care across the full spectrum of health care services. Fairview is one of the most comprehensive and geographically accessible systems in the state, with 10 hospitals—including an academic medical center and long-term care hospital—serving the greater Twin Cities metro area.
Its broad continuum also includes 60 primary care clinics, specialty clinics, senior living communities, retail and specialty pharmacies, pharmacy benefit management services, rehabilitation centers, counseling and home health care services, medical transportation, an integrated provider network and health insurer PreferredOne. In partnership ...with the University of Minnesota, Fairview’s 32,000 employees and 2,400 affiliated providers embrace innovation to drive a healthier future through healing, discovery and education.
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