Regulatory Oversight Lead — Clinical Trials Billing

Vanderbilt University Medical Center; United States; Remote; USD 90,000 - 120,000; Full time

Job summary

Vanderbilt Health is seeking a Regulatory Oversight Specialist – Research to plan and lead projects ensuring the integrity of billing for research related activities. The role covers prospective and retrospective reviews of study protocols, billing grids, and charge segregation with emphasis on CMS regulations and EPIC documentation.

The candidate will work independently, analyze data in Excel, and provide concise PowerPoint summaries to Revenue Cycle, Compliance, and Research Administration

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, Coverage with Evidence Development guidelines, EPIC documentation and insurance/billing.
• Perform special projects related to compliance matters as requested by Compliance and Legal offices.
• Analyze data files in Excel to evaluate compliance and document findings and recommendations.
• Lead complex financial, operational, reimbursement, and business analyses.
• Interpret and communicate analytical findings to leadership and present to executive management.

Skills

Research Administration

Clinical Trials Management

Revenue Cycle

Auditing

Education

Bachelor’s Degree

Tools

OnCore

EPIC

Job description

Vanderbilt Health is seeking a Regulatory Oversight Specialist – Research to plan and lead projects ensuring the integrity of billing for research related activities. The role covers prospective and retrospective reviews of study protocols, billing grids, and charge segregation with emphasis on CMS regulations and EPIC documentation.

The candidate will work independently, analyze data in Excel, and provide concise PowerPoint summaries to Revenue Cycle, Compliance, and Research Administration