Clinical Trials Billing Compliance Specialist

Vanderbilt Health; Nashville (TN); Remote; USD 100,000 - 140,000; Full time

Job summary

Vanderbilt Health seeks a Regulatory Oversight Specialist - Research (non-supervisory) to plan and lead projects managing clinical research billing and compliance. Responsibilities include reviewing study protocols, creating billing grids, and auditing CMS billing rules for government and sponsor payments.

The role requires strong analytical and regulatory knowledge of clinical trials billing, and the ability to present concise PowerPoint summaries to leadership.

Qualifications

• Bachelor's Degree and 10 years of relevant work experience in Research Administration, Clinical Trials Management, Revenue Cycle, Consulting or Auditing in a Large Academic Medical Center.
• CHRC (Certification in Healthcare Research Compliance) and/or CHC (Certified in Healthcare Compliance) preferred.
• Familiarity with OnCore Clinical Trials Management System strongly preferred.

Responsibilities

• Lead prospective and retrospective reviews of study protocols, billing grid development and research charge segregation functions.
• Analyze compliance with CMS regulations for billing of research studies and clinical registries by auditing Medicare Coverage Analysis and related billing activities.
• Perform special projects related to compliance matters as requested by Office of Compliance and Corporate Integrity and/or Office of Legal Counsel.
• Analyze data files in Excel to evaluate criteria under review and document findings and recommendations clearly.
• Lead complex financial, operational, reimbursement, and business analyses.

Education

Bachelor's Degree

Tools

OnCore Clinical Trials Management System

Job description

Vanderbilt Health seeks a Regulatory Oversight Specialist - Research (non-supervisory) to plan and lead projects managing clinical research billing and compliance. Responsibilities include reviewing study protocols, creating billing grids, and auditing CMS billing rules for government and sponsor payments.

The role requires strong analytical and regulatory knowledge of clinical trials billing, and the ability to present concise PowerPoint summaries to leadership.