Clinical Practice Data Analyst (Research Billing Analyst) - UI Health, Revenue Cycle

The Research Billing Analyst provides specialized analytical support of research charges for the UI Health Revenue Cycle, Clinical Research Finance Office (CRFO). The Research Billing Analyst is an integral member of the Office of Clinical Research Finance. Under the direction of the Assistant Director, Clinical Research Finance, 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:

• Primary role is to analyze and manage accounts where services related to a clinical trial are involved
• Ensures 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.
• Reviews the medical record identifying the research informed consent along with applicable research medical documentation and segregate potential research charges using guidance provided such as Coverage Analysis, study participant tracking calendars, and clinical trial management systems (CTMS).
• Serves as the centralized point of contact for specific billing issues related to research billing.
• Work assignments are complex requiring strong analytical, investigative, and evaluative skills and the ability to contribute to and provide accountability for managing/leading small projects or portions of projects.
• Accesses databases, UI Health electronic health record (EHR) and utilizes reporting tools to extract data, generate reports, perform data analysis, and draft system/process improvement recommendations.
• Assignments require interfacing with clinical trial management systems, gathering information from and making presentations to various operational areas of UI Health Clinical Research Revenue Cycle, the Offices of the Vice Chancellor for Research (OVCR), and the UIC research community.
• 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.
• Analyzes, evaluates and interprets data, processes, systems, policies, regulations and internal controls.
• Conducts impact analyses and modeling, assesses trends, identifies risks, develops projections, determines opportunities and prepares detailed written summaries for management review and decision-making.
• Participates in and serves as a subject matter resource in the development of process improvement initiatives which support business needs and enhance the performance of an operational area of Clinical Research Revenue Cycle.
• Assists in identifying operational and clinical research financial metrics and provides appropriate interpretation and application of data.
• Assists with the design, development, implementation, and maintenance of systems that provide clinical research financial, and operational information.
• Knowledge and experience with CMS regulations including National Coverage Determination 310.1 Clinical Trial Policy
• Ensures the Epic Research Study Record is correctly populated with the data elements per operational requirements for clinical trial associated billing accounts.
• Produces research financial reporting, including invoicing departments for study sponsored charges.
• Serves as a contact to the Research community in problem resolution and the monthly distribution of research related transactions.
• Routinely interacts with internal departments, study teams, and provide training related to research billing.
• Other duties as assigned.