Hybrid Research Billing Compliance Specialist

University of Michigan; Ann Arbor (MI); Hybrid; USD 70,000 - 100,000; Full time

Benefits offered by this job

Medical coverage

Retirement match

Job summary

University of Michigan's Michigan Medicine is seeking an Intermediate Research Billing Compliance Specialist to review, adjudicate, and process clinical research charges in alignment with coverage analysis and CTAs. This role collaborates with research teams, billing partners, and compliance staff to ensure accurate charge routing and timely issue resolution.

Hybrid work options may be available; candidates should have experience with Medicare/third-party payer guidelines, CPT/HCPCS coding, and

Qualifications

• Bachelor's degree in Business, Finance, Health Information Management, or related field; or equivalent experience/certifications.
• 3+ years in healthcare revenue cycle or clinical operations with billing/compliance experience.
• Knowledge of CMS rules incl. NCD 310.1 and Local Coverage Determinations.
• Familiarity with CPT/HCPCS coding and UB-04/1500.
• Experience with electronic health record systems.

Responsibilities

• Analyze and perform complex daily review of hospital/professional charges for clinical trials to determine charge segregation.
• Ensure charges are routed with correct modifiers, diagnoses and documentation for compliant billing.
• Resolve denials in collaboration with revenue cycle billing; escalate complex issues as needed.
• Identify variances between hospital and professional entries against required coverage analysis.
• Respond to inquiries and support accurate, compliant research billing practices.

Skills

CMS billing rules

CPT/HCPCS coding

EHR systems

Medicare NCD 310.1

Education

Bachelor's degree or equivalent

Tools

MiChart

OnCore

Job description

University of Michigan's Michigan Medicine is seeking an Intermediate Research Billing Compliance Specialist to review, adjudicate, and process clinical research charges in alignment with coverage analysis and CTAs. This role collaborates with research teams, billing partners, and compliance staff to ensure accurate charge routing and timely issue resolution.

Hybrid work options may be available; candidates should have experience with Medicare/third-party payer guidelines, CPT/HCPCS coding, and