Clinical Research Billing Compliance Specialist

University of Wisconsin–Madison; Madison (WI); On-site; USD 55,000 - 75,000; Full time

Job summary

Jobtailor is seeking a detail-oriented professional to join our team as a Clinical Trial Budgeting and Medicare Coverage Analyst. You will develop internal quality controls for calendar and budget builds and ensure compliance with research billing rules across complex studies.

You will analyze Medicare coverage for trials, collaborate with study teams to maintain billing integrity, and interpret clinical protocols to configure calendars and budgets.

Qualifications

• 1–2 years of experience in Clinical Trial Budgeting and Medicare Coverage Analysis.
• Experience with budgeting and/or post-award management.
• Experience in a medical and/or research setting.
• Experience with medical or insurance billing preferred.
• Associate’s degree required; focus in finance or accounting preferred.

Responsibilities

• Develop and implement internal quality control processes for calendar and budget builds.
• Perform Medicare coverage analysis for complex studies to ensure compliance with billing rules.
• Collaborate with study teams to ensure billing compliance.
• Interpret complex clinical trial protocols to configure and review study calendars and budgets.
• Oversee research billing compliance activities to align with regulations.
• Advise researchers on proper setup and execution of billing activities for trials.
• Provide training and resources related to research billing to study teams.
• Provide expert guidance during reconciliation of charges to ensure accurate billing.
• Identify and implement changes in calendar setup as needed.

Skills

Medicare Coverage Analysis

Clinical Trial Budgeting

Budgeting

Post-award Management

Medical Billing

Education

Associate’s degree in finance or accounting

Job description

Responsibilities

• Develop and implement internal quality control processes to ensure calendar and budget builds reflect accurate trial information and comply with research billing rules.
• Perform Medicare coverage analysis for complex research studies to promote and confirm compliance with billing rules and regulations.
• Work with study teams to ensure compliance.
• Interpret complex clinical trial protocols while applying expertise in research billing rules, clinical workflows, sponsor requirements, and electronic system capabilities to configure and review study calendars and budget setup for clinical trials.
• Oversee research billing compliance activities to ensure the unit is in full compliance with institutional, regional, and federal research billing compliance rules and regulations.
• Advise researchers on the proper set up and execution of billing activities for patients on clinical trials.
• Provide training and resources related to research billing to study teams.
• Provide expert guidance when issues arise during reconciliation of unit patient charges to ensure appropriate billing.
• Identify and implement changes in clinical trial protocol calendar set up as needed.

Requirements

• 1–2 years of employment experience in Clinical Trial Budgeting and Medicare Coverage Analysis (required by the start date).
• Experience with budgeting and/or post-award management.
• Experience in a medical and/or research setting.
• Experience with medical or insurance billing preferred.
• Associate’s degree required; a focus in finance or accounting preferred.