Clinical Trials Billing Specialist

Duke; Durham (NC); Remote; USD 50,000 - 70,000; Full time

Job summary

Duke Health is seeking a Clinical Trials Billing Specialist for its Patient Revenue Management Organization. This remote position involves ensuring accurate billing practices for patients in clinical trials, while working closely with healthcare providers and ensuring compliance with federal regulations.

Qualifications

• Four years of related experience in healthcare required; Bachelor's degree can substitute.
• Must understand Medicare rules for billing clinical trials.

Responsibilities

• Ensure accurate billing for clinical trials and create databases for trials.
• Educate providers on compliance with regulations.

Skills

Communication

Knowledge of federal regulations

Education

High school diploma or equivalent

Post-secondary courses in Accounting, Finance, or Business Administration

Tools

IDX

Siemens

DHIS

Job description

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At Duke Health, we're driven by a commitment to compassionate care that changes the lives of patients, their loved ones, and the greater community. No matter where your talents lie, join us and discover how we can advance health together.

About Duke Health's Patient Revenue Management Organization

Pursue your passion for caring with the Patient Revenue Management Organization, which is Duke Health's fully integrated, centralized revenue cycle organization that supports the entire health system in streamlining the revenue cycle. This includes scheduling, registration, coding, billing, and other essential revenue functions.

Clinical Trials Billing Specialist

100% Remote Position

Schedule: Monday-Friday 8:00am-5:00pm

Reporting to the Manager, Clinical Trials Billing Integrity, this non-exempt, remote position is a part of the Clinical Trials Billing Team of Duke's Patient Revenue Management Organization (PRMO). The primary role is to facilitate accurate billing for patients enrolled in clinical trials in accordance with federal regulations to reduce both institution al and individual provider legal and financial risk.

General Description of the Job Class

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.

Duties and Responsibilities of this Level

• Ensure that charges associated with grants and clinical trials are billed appropriately for both physician and hospital services.
• Create a central database for grants and clinical trials that is consistently used throughout the health system.
• Monitor and maintain the database and provide instruction to all new users.
• Educate providers regarding compliance with government regulations with special attention to CMS guidelines as they pertain to billing for patients enrolled in clinical trials.
• Collaborate with physicians, business managers and clinical research coordinators in the development of improved capabilities in the areas of billing and compliance.
• Identify risk areas and implement corrective action.
• Provide education to all clinical research staff on how to register patients for enrollment in trials and how to properly identify charges that are grant related versus standard of care.
• Assist in the analysis of processes and recommend changes and/or modifications to meet compliance and customer service goals.
• Create weekly reports for clinical research staff to review reducing customer service issues by correctly identifying charges that are grant related.
• Facilitate communication between the clinical research coordinators and the CDM department to insure compliance with DUHS and SOM rules regarding uniform discounted fees for clinical trials.
• Represent the PRMO in actively promoting initiatives with clinical faculty and administration.
• Perform other related duties incidental to the work described herein.

Required Qualifications at this Level

Education
High school diploma or equivalent is required, preferably supplemented by post-secondary courses in Accounting, Finance, Economics, Business Administration or a related field.

Experience, Degrees, Licensure, and/or Certification
Four years of related experience in healthcare is required. A Bachelors degree in a related field can substitute for the experience requirement.

Knowledge, Skills, and Abilities

• Must possess an understanding of federal regulations as they pertain to Medicare rules for billing clinical trials.
• System experience may include: IDX, Siemens, DHIS.
• Good communication skills (verbal and written) are essential.

Distinguishing Characteristics of this Level

The intent of this job description is to provide a representative and level of the types of duties and responsibilities that will be required of positions given this title and shall not be construed as a declaration of the total of the specific duties and responsibilities of any particular position. Employees may be directed to perform job-related tasks other than those specifically presented in this description.

Duke University is an Affirmative Action/Equal Opportunity Employer committed to providing employment opportunity without regard to an individual's age, color, disability, gender, gender expression, gender identity, genetic information, national origin, race, religion, sex, sexual orientation, or veteran status.

Duke aspires to create a community built on collaboration, innovation, creativity, and belonging. Our collective success depends on the robust exchange of ideas-an exchange that is best when the rich diversity of our perspectives, backgrounds, and experiences flourishes. To achieve this exchange, it is essential that all members of the community feel secure and welcome, that the contributions of all individuals are respected, and that all voices are heard. All members of our community have a responsibility to uphold these values.

Essential Physical Job Functions

Certain jobs at Duke University and Duke University Health System may include essential job functions that require specific physical and/or mental abilities. Additional information and provision for requests for reasonable accommodation will be provided by each hiring department.

Duke is an Equal Opportunity Employer committed to providing employment opportunity without regard to an individual's age, color, disability, gender, gender expression, gender identity, genetic information, national origin, race, religion, sex (including pregnancy and pregnancy related conditions), sexual orientation or military status.

Duke aspires to create a community built on collaboration, innovation, creativity, and belonging. Our collective success depends onthe robust exchange of ideas—an exchange that is best when the rich diversity of our perspectives, backgrounds, and experiences flourishes. To achieve this exchange, it is essential that all members of the community feel secure and welcome, that the contributions of all individuals are respected, and that all voices are heard. All members of our community have a responsibility to uphold these values.

Essential Physical Job Functions: Certain jobs at Duke University and Duke University Health System may include essential job functions that require specific physical and/or mental abilities. Additional information and provision for requests for reasonable accommodation will be provided by each hiring department.

Nearest Major Market: Durham
Nearest Secondary Market: Raleigh

Duke is an Affirmative Action / Equal Opportunity Employer committed to providing employment opportunity without regard to an individual’s age, color, disability, gender, gender expression, gender identity, genetic information, national origin, race, religion, sex, sexual orientation, or veteran status. Read more about Duke’s commitment to affirmative action and nondiscrimination at hr.duke.edu/eeo.