Research Decision Support Analyst

be a super user of the Clinical Trial Management System (CTMS) and will be responsible for maintaining the study portfolio in the CTMS which includes support in the following areas: financials, Medicare coverage analysis, accrual and data reports, study builds, and study amendments.

This position will be responsible for billing review for clinical trials patients based on Medicare Coverage rules and Clinical Trial contracts to ensure proper compliance and reimbursement.

This position requires advanced knowledge of research program billing requirements, as well as Medicare, Medicaid, and federal research billing rules. The incumbent actively participates in internal audits, maintains documentation of current workflows, assists with special projects, and works closely with Billing, Office of Research Compliance, IT, and other stakeholders.

Minimum Requirements

Education
• Bachelor’s Degree

Experience
• 3+ years’ experience in Clinical Research

License/Registration/Certifications
• N/A

Preferred Requirements

Preferred Education
• Advanced Degree

Preferred Experience
• Manager or Coordinator experience
• 2+ years’ experience with statistical analysis
• Experience in a healthcare revenue cycle or clinic operations role
• Epic billing experience

Preferred License/Registration/Certifications
• Certified Medical Coder (CMC)

Core Job Responsibilities
• Working knowledge of the Clinical Research Department processes and procedures related to Research
• Must be able to work with Clinical Research staff, doctors, departments, community, and other internal or external customers
• Reviews study budget with research staff to ensure all relevant study costs have been included
• Builds budgets in CTMS
• Assists with tracking of department financials including invoice and reconciliation processes. Monitors receipt of clinical trial payments from Sponsors
• Reviews research patient care items and services against a Medicare Coverage Analysis and segregate the charges by applicable payor type
• Proactive and independent line-item review of charge related items/encounters
• Ensures the accuracy and completeness of research-related charges within EPIC for accurate and timely billing to study accounts, insurance/Medicare, and/or the patient
• Works closely with business office and finance/billing department with complex billing and reimbursement issues associated with research patient’s accounts
• Must be able to effectively serve in a leadership role with the various teams of the Clinical Research Department
• Attention to detail, excellent organizational skills
• Must be self-directed, motivated, and able to work independently
• Must be flexible in responsibilities and work schedule
• MS Office experience
• Other duties as assigned