Billing Specialist- Research Trials

Children's Hospital of Philadelphia; Philadelphia (Philadelphia County); On-site; USD 45,000 - 75,000; Full time

Job summary

An established industry player in pediatric healthcare is seeking a Billing Specialist to join their dynamic team. In this role, you will facilitate accurate billing for patients enrolled in clinical trials, ensuring compliance with federal regulations. You will act as a subject matter expert, managing projects, and maintaining workflows while collaborating across departments. This is an exciting opportunity to contribute to a mission-driven organization that values diversity and innovation in healthcare. If you have a strong background in billing and a passion for making a difference, this position is perfect for you.

Qualifications

• 3+ years in healthcare billing or collections required.
• Strong math and organizational skills essential for success.

Responsibilities

• Manage billing processes for clinical trials, ensuring compliance.
• Analyze workflows and identify opportunities for improvement.

Skills

Mathematical Aptitude

Organizational Skills

Decision Making

Leadership

Detail Oriented

Interpersonal Skills

Writing Skills

Oral Communication

Independence

Confidentiality Handling

Education

High School Diploma / GED

Bachelor's Degree

Tools

Excel

Epic System

Job description

SHIFT:

Day (United States of America)

Seeking Breakthrough Makers

Children’s Hospital of Philadelphia (CHOP) offers countless ways to change lives. Our diverse community of more than 20,000 Breakthrough Makers will inspire you to pursue passions, develop expertise, and drive innovation.

At CHOP, your experience is valued; your voice is heard; and your contributions make a difference for patients and families. Join us as we build on our promise to advance pediatric care—and your career.

CHOP’s Commitment to Diversity, Equity, and Inclusion

CHOP is committed to building an inclusive culture where employees feel a sense of belonging, connection, and community within their workplace. We are a team dedicated to fostering an environment that allows for all to be their authentic selves. We are focused on attracting, cultivating, and retaining diverse talent who can help us deliver on our mission to be a world leader in the advancement of healthcare for children.

We strongly encourage all candidates of diverse backgrounds and lived experiences to apply.


A Brief Overview
The billing specialist will 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. They will ensure that both professional and hospital claims include correct identifiers and are compliant with government regulations with special attention to CMS guidelines as they pertain to billing for patients enrolled in clinical trials. In conjunction with Clinical Trials Financial Management who handles the first tier, this role will serve as the second tier review for the two-tier billing process to confirm charges will be routed to the appropriate funding source based on the linked clinical trial protocol in both Epic and OnCore (CTMS system).

What you will do

• Acts as subject matter expert in their department, manages projects to timely completion, troubleshoots issues and maintains accurate and compliant workflows.
• Holds inter-departmental relationships within PFS and outside of PFS; manages assigned workflows and work queues associated with these relationships and is the primary communicator with the department for any improvement opportunities.
• Monitors work queues assigned as their responsibility, meeting established production and quality standards for the assigned tasks.
• Specific focus is project oriented; identifies trends, training opportunities, denial prevention initiatives and maintains internal controls for the department.
• Performs workflow analysis, documents workflows, and testing planning in support of departments strategic and operational objectives.
• Stays current on regulations and industry standard trends to ensure CHOP is compliant.
• Responsible for creating presentation and data analytics to drive change and improvements.
• Documents processes to help keep revenue cycle stakeholders informed and identify optimization opportunities.
• Other duties as assigned.

Education Qualifications

• High School Diploma / GED Required
• Bachelor's Degree Preferred

Experience Qualifications

• At least three (3) years of work experience in healthcare billing or collections environment or other related role required.
• Demonstrated success in resolution of patient accounts; demonstrated ability to identify trends and complete assignments timely required.

Skills and Abilities

• Strong math aptitude required.
• Excellent organizational skills required.
• Clear and concise decision making skills required.
• Leadership skill required.
• Detail oriented required.
• Strong interpersonal skills required.
• Excellent writing and oral communication skills required.
• Ability to work independently; results oriented required.
• Ability to handle confidential matters required.
• Flexibility to work overtime as needed/required required.
• Experience with personal computers including Excel required.
• Experience with Epic system preferred.

To carry out its mission, CHOP is committed to supporting the health of our patients, families, workforce, and global community. As a condition of employment, CHOP employees who work in patient care buildings or who have patient facing responsibilities must be fully vaccinated against COVID-19 and receive an annual influenza vaccine. Learn more.

Employees may request exemptions for valid religious and medical reasons. Start dates may be delayed until candidates are immunized or exemption requests are reviewed.

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