Reimbursement Coding Specialist (Research Billing Analyst II) - Revenue Cycle

Hiring Department: Revenue Cycle

Location: Chicago, IL USA

Requisition ID: 1016765

Posting Close Date: August 24, 2023

Position Number: CE6871,CE6872

About the University of Illinois Hospital & Health Sciences System (UI Health)

The University of Illinois Hospital & Health Sciences System (UI Health) provides comprehensive care, education, and research to the people of Illinois and beyond. A part of the University of Illinois at Chicago (UIC), UI Health comprises a clinical enterprise that includes a 495-bed tertiary care hospital, 22 outpatient clinics, and 13 Mile Square Health Center facilities, which are Federally Qualified Health Centers. It also includes the seven UIC health science colleges: the College of Applied Health Sciences; the College of Dentistry; the School of Public Health; the Jane Addams College of Social Work; and the Colleges of Medicine, Pharmacy, and Nursing, including regional campuses in Peoria, Quad Cities, Rockford, Springfield, and Urbana. UI Health is dedicated to the pursuit of health equity.

This is a full-time and benefits eligible position. UIC offers competitive salaries commensurate with experience. In addition all full time benefits eligible positions include a comprehensive benefits package which include; Health, Dental, Vision, Life, Disability & AD&D insurance, a defined benefit pension plan as well as paid leave which includes; Vacation, Holiday and Sick. In addition we offer tuition waivers for employees and dependents. Click for a complete list of Employee Benefits

Description:

The Reimbursement Coding Specialist (Research Billing Analyst II) is an integral member of the Office of Clinical Research Finance. Under the direction of the Clinical Research Finance Director, the Research Billing Analyst will promote and facilitate a culture of research financial compliance according to established research billing best practices, policies and procedures for clinical research studies to ensure institutional adherence with Federal, State, and Local Regulations and Guidelines.
Duties & Responsibilities:

• Monitor and manage accounts where services related to a clinical trial are involved.

• Ensure that all charges for facility and professional fees arising from clinical research protocol visits and services are consistently segregated and billed to the appropriate payer and/or sponsor, submitted on correct claims with proper codes, modifiers and NCT number, and properly reimbursed, avoiding efforts in managing denials and mitigating risks of double-billing to both a study sponsor and an insurer.

• Review and work potential research charges using guidance provided such as Coverage Analysis, study participant tracking calendars, clinical trial management systems (CTMS), correct coding initiatives (CCI) and coding guidelines.

• Utilizes coding expertise and sound knowledge of medical coding rules and regulations in the context of clinical research trials to assign CPT codes to the items and services listed on the Coverage Analysis and make sure that issues related to compliance reimbursement bundling, unbundling and fragmentation of coding information are considered addressed prior to claims adjudication.

• Identifies medical claims system coding issues.

• Coordinates with the revenue cycle claims team to investigate rejected or denied claims to see why denial was issued and work in collaboration with other areas to correct.

• Ensure the Epic Research Study Record is correctly populated with the data elements per operational requirements for clinical trial associated billing accounts.

• Responsible for producing research financial reporting, including invoicing departments for study sponsored charges.

• Serve as an important contact to the Research community in problem resolution and the monthly distribution of research related transactions.

• Routinely interact with internal departments, study teams, and provide training related to research billing when needed.

• Serve as a centralized point of contact for specific billing issues related to research billing.

• Assist in training research coordinators on proper billing for clinical trials and participate in ongoing research education seminars. Target areas of concentration where notification and documentation standards are not met.

• Willingness to engage in continual education and training in the subject field.

• Participate in department projects and initiatives to support research billing compliance tasks as needed. Assigned to special projects as they occur.

• Performs duties listed in lower level of this classification series.

• Performs other related duties as assigned.
• Perform other related duties and participate in special projects as assigned.

Minimum Qualifications Required:

Preferred Qualifications:

• Demonstrated experience with research and clinical trial billing and reimbursement.
• Knowledge and experience with CMS regulations including National Coverage Determination 310.1 Clinical Trial Policy, CDM codes, CPT codes, diagnosis codes, modifiers, federal regulatory guidelines and healthcare billing.
• Epic experience.
• Familiarity with Microsoft Office products.

To Apply: For fullest consideration click on the Apply Now button, please fully complete all sections of the online application including adding your full work history with specific details of your duties & responsibilities for each position held. Fully complete the education, licensure, certification and language sections. You may upload a resume, cover letter, certifications, licensures, transcripts and diplomas within the application.

Please note that once you have submitted your application you will not be able to make any changes. In order to revise your application you must withdraw and reapply. You will not be able to reapply after the posting close date. Please ensure the application is fully completed and all supporting documents have been uploaded before the posting close date. Illinois Residency is required 180 days of employment.

The University of Illinois System is an equal opportunity employer, including but not limited to disability and/or veteran status, and complies with all applicable state and federal employment mandates. Please visit Required Employment Notices and Posters to view our non-discrimination statement and find additional information about required background checks, sexual harassment/misconduct disclosures, COVID-19 vaccination requirement, and employment eligibility review through E-Verify.

The university provides accommodations to applicants and employees. Request an Accommodation