Hybrid-Remote Clinical Research Billing & Compliance

Michigan Medicine; Ann Arbor (MI); Hybrid; USD 65,000 - 90,000; Full time

Benefits offered by this job

Excellent medical, dental and vision

2:1 retirement savings match

Job summary

Michigan Medicine seeks an Intermediate Research Billing Compliance Specialist to review and adjudicate clinical research charges in alignment with CA grids and CTAs. You will ensure accurate charge routing, documentation, and timely resolutions within a high-volume research revenue cycle environment.

Reporting to the Research Billing Compliance Lead, you will collaborate with study teams, billing partners, and compliance staff to maintain regulatory compliance, resolve denials, and support

Qualifications

• Bachelor's degree in Business, Finance, Health Information Management, or related field, or equivalent experience.
• Minimum of three years in healthcare revenue cycle or clinical operations with billing/compliance experience.
• Knowledge of CMS rules including National Coverage Determinations and Local Coverage Determinations.
• Familiarity with CPT/HCPCS coding and UB-04/1500 hospital billing.
• Experience with electronic health record systems.

Responsibilities

• Analyze and perform complex daily review of hospital and/or professional charges for clinical trials to determine charge segregation using CA grids and documentation.
• Ensure research charges are routed accurately with appropriate modifiers, diagnoses, and documentation for compliant billing.
• Partner with revenue cycle billing to resolve research-related denials.
• Escalate complex or non-standard billing issues to Senior/Lead staff.
• Identify variances between hospital and professional entries against Coverage Analysis for compliant routing.
• Maintain up-to-date understanding of Medicare Clinical Trial Policy (NCD 310.1), FDA regulations, and related statutes.
• Respond to research billing inquiries from study teams and research staff.
• Collaborate with internal stakeholders to support accurate and compliant research billing practices.

Skills

CMS billing rules

CPT/HCPCS coding

Electronic health records

Education

Bachelor's degree in Business, Finance, Health Information Management, or related field

Job description

Michigan Medicine seeks an Intermediate Research Billing Compliance Specialist to review and adjudicate clinical research charges in alignment with CA grids and CTAs. You will ensure accurate charge routing, documentation, and timely resolutions within a high-volume research revenue cycle environment.

Reporting to the Research Billing Compliance Lead, you will collaborate with study teams, billing partners, and compliance staff to maintain regulatory compliance, resolve denials, and support