Billing Specialist I Clinical Trials

Job Summary: Processes non-industry sponsored claims and all professional fees associated with clinical trial patients, in a timely and accurate basis. Ensures compliance of claims processing in accordance with insurance guidelines. Responsible for the day-to-day activities related to resolution of patient accounts up to and including: adding NCT ID#s, identifying information that was missing or posted in error, and releasing billing edits. Abstracts codes to facilitate an accurate database for research, planning, statistics and financial reimbursement.

Responsibilities:

• Performs daily review and reconciliation of billing edits for patients on non-industry sponsored trials.

• Verifies eligibility of clinical trail patients from database (clinical trials management system (CTMS) OnCore).

• Enter NCT ID# in AMPFM for all non-industry sponsored trials and release for billing.

• Review and correct daily billing edit spreadsheet for bad NCT ID#s in AMPFM.

• Review and process all professional fees associated with clinical trial patients and supply NCT ID#s to vendors for insurance claims.

Qualifications:

• Bachelor's Degree required with minimum of 1-2 years previous work experience in patient accounting; or equivalent combination of education and experience.

• Demonstrated understanding of ICD-9-CM, CPT-4 (HCPCS) coding protocols, and government regulations. Knowledge of edit reports in advance of electronic billing preferred.

• Knowledge of accounts invoices and accounts receivable preferred.

• Comprehensive knowledge of medical terminology, anatomy & physiology, pharmacology, disease processes, surgical and medical procedures.

• Computer application skills: Windows, Word, Excel, Outlook, Oncore and CITRIX/CIS.

Equal Opportunity Employer of Minorities/Females/Disabled/Veterans

Additional Information

• Schedule: Full-time

• Requisition ID: 24002575

• Daily Work Times: 7 am - 3:30 pm

• Hours Per Pay Period: 40

• On Call: No

• Weekends: No

Equal Opportunity Employer

McLaren Health Care is an Equal Opportunity Employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, sexual orientation, gender identification, age, sex, marital status, national origin, disability, genetic information, height or weight, protected veteran or other classification protected by law.