Clinical Research Billing Specialist AdventHealth Tampa
Location Address: 3100 East Fletcher Avenue Tampa, Florida 33613
Top Reasons to Work at AdventHealth Tampa:
AdventHealth Pepin Heart Institute, known across the country for its advances in cardiovascular disease prevention, diagnosis, treatment and research.
Surgical Pioneers – the first in Tampa with the latest robotics in spine surgery
Building a brand new, six story surgical and patient care tower which will ensure state of the art medical and surgical car for generations to come
Awarded the Get With The Guidelines – Stroke GOLD Quality Achievement Award from the American Heart Association/American Stroke Association and have been recognized as a recipient of their Target: Stroke Honor Roll for our expertise in stroke care. We have also received certification by The Joint Commission in collaboration with the American Stroke Association as a Primary Stroke Center.
SHIFT Full-time Days
You will be responsible for:
Demonstrates through behavior Florida Hospital’s Core Values of Integrity, Compassion, Balance, Excellence, Stewardship and Teamwork as outlined in the organization’s Performance Excellence Program.
Ensures that charges associated with grants and clinical trials are billed appropriately for both physician and hospital services.
Educates providers regarding compliance with government regulations with special attention to CMS guidelines as they pertain to billing for patients enrolled in clinical trials.
Acts as a liaison between patient financial services, facility research director and system reimbursement services for communicating information regarding the National Coverage Decision for clinical trials and other federal research regulations
Collaborates with physicians, business managers and clinical research coordinators in the development of improved capabilities in the areas of billing and compliance. Identify risk areas and implement corrective action.
Provides education to all clinical research staff on how to register patients for enrollment in trials and how to properly identify charges that are research related versus standard of care.
Facilitates communication between the clinical research coordinators and 3rd party vendors to insure corporate compliance with hospital rules regarding uniform discounted fees for clinical trials.
Effective communication and high-level of interpersonal skills required to interact with sponsors, physicians, colleagues, facility administrators and patient financial services.
Reviews research contracts and budgets to maintain compliance and ensure proper reimbursement and study billing requirements are met.
Accurately establishes codes for diagnostic and procedural information on research inpatient and outpatient billing grids according to ICD or CPT principles and conventions within established time frames.
Reviews accounts receivable on all research studies.
Tracks amount due from sponsors, receipt of sponsor checks and budget releases for all industry sponsored clinical trials.
Reviews sponsor receipts against patient activity to ensure that all revenues due are received and resolves any discrepancies.
Responsible for clinical trial billing compliance, maintains all study participant tracking sheets. Enters information on all completed visits and subject enrollments on an on-going basis.
Works with coordinators to resolve any inconsistencies or questions regarding specific visit items. Reviews and updates all tracking sheets at least monthly; no tracking sheet shall be more than one month behind with respect to subject enrollments and completed visits.
Enters all invoices received from service providers in the appropriate study tracking sheets when received.
Processes research bills for clinical trial procedures and professional services and patient stipends.
Adheres to research institute clinical trials billing compliance policies and procedures.
Utilizes data from study participant tracking sheets to determine specifically which services are to be paid by the study and coordinates closely with service providers and with coordinators to ensure that all study bills are received and paid on a timely basis.
Assists business office in monitoring patient reimbursement activity and to bill the sponsor (when appropriate) if denied from insurance company.
Reviews on at least a monthly basis all completed visits in tracking sheets to identify services for which provider invoices have not been received. Contacts service providers to request invoices that have not yet been received and follow up on requests if necessary.
Responds promptly to inquiries from service providers.
Responsible for account closeouts.
Collaborates with Director of Research on closeout of industry sponsored clinical trials and NIH grants, if needed. Verifies expenses and revenue; review and validates federal financial reports in conjunction with campus finance, as requested.
Coordinates administrative duties for Research Administration, as needed
Other duties as assigned, including serving as backup to execute purchase orders, encumbrances, disbursements for research group.
Performs random patient account audits, as needed, to ensure compliance and informs Research Director of findings.
Assists in the analysis of processes and recommend changes and/or modifications to meet compliance and goals.
Works closely with staff in the study approval process, meets project timelines and department goals towards optimal clinical, operational, financial and satisfaction outcomes.
Creates monthly reports for clinical research staff to review enrollment goals.
Monitors and maintains a database for grants and clinical trials that is consistently used throughout the health system and provide instruction to users, as needed.
KNOWLEDGE AND SKILLS REQUIRED:
Work generally requires organizational, analytical and communication skills.
Effective communication skills (both verbal and written) are essential.
Possess a good understanding of financial systems, Microsoft Word and Excel.
KNOWLEDGE AND SKILLS PREFERRED:
Demonstrates and applies knowledge of government billing regulations specific to research to develop and supervise billing compliance systems and finance policies as well as preparation of reports for use in planning and decision-making.
EDUCATION AND EXPERIENCE REQUIRED:
High school diploma or GED equivalent.
EDUCATION AND EXPERIENCE PREFERRED:
Bachelor’s Degree in Medical Billing and Coding, or similar discipline or accounting experience in lieu of degree.
2 years in hospital and/or physician billing or equivalent preferred.
Preferred additional experience in a patient financial services position or a utilization/care management role.
Possess a good understanding of research clinical trial management system application.
Conversant in reimbursement methodologies, cost accounting systems and familiarity with research regulations.
At AdventHealth, Extending the Healing Ministry of Christ is our mission. It calls us to be His hands and feet in helping people feel whole. Our story is one of hope — one that strives to heal and restore the body, mind and spirit. Our more than 80,000 skilled and compassionate caregivers in hospitals, physician practices, outpatient clinics, urgent care centers, skilled nursing facilities, home health agencies and hospice centers are committed to providing individualized, wholistic care.