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Expected pay for this position is $33.52 - $39.44/hour. Actual pay will be determined by experience, skills and internal equity. This is a Salaried position.
Overview
Please note: H-1B sponsorship is not offered for this opening(s).
This positon would offer the option to work full remote near an OSF HealthCare location which includes but not limited to locations within the Illinois region of: Peoria/Bloomington, Rockford/Dixon, Alton, Urbana/Danville, Evergreen Park, Ottawa/Peru/Princeton, Galesburg/Kewanee/Mendota
POSITION SUMMARY: As a pivotal member of our clinical research team, the Clinical Research Billing (CRB) Analyst I plays a crucial role in overseeing the financial aspects of clinical trials within our highly regulated field. This role involves compiling and analyzing diverse data, particularly focusing on Medicare Coverage Analysis (MCA), to ensure compliance with strict industry regulations. Collaborating with cross-functional teams, the Analyst supports study start-ups, aligning budgets with trial scopes and ensuring regulatory adherence. Additionally, they meticulously review MCAs against protocols, ensuring accurate billing. Beyond these responsibilities, the Analyst provides financial insights for new research grants, manages industry and grant funds post-award, and oversees invoicing and cash flow for funded trials. They manage research financial data, conduct comprehensive analyses, and provide essential education and support to research operations staff regarding finance, billing processes, policies, and regulations. This role also involves spearheading special projects and quality assurance initiatives for timely invoicing and efficient monetary tracking.
PRIMARY JOB RESPONSIBILITIES AND ACCOUNTABILITY:
Supports study start-up creation and review activities of internal budgets, Medicare Coverage Analysis MCAs, and agreements, collaborating with cross-functional teams to navigate the specific financial intricacies of our industry.
Reviews new research grants, providing financial insight, and collaborating with stakeholders for seamless integration into our specialized financial systems.
Conducts a thorough review of the MCA against the protocol to ensure compliance and accurate billing within the regulatory framework of our niche industry.
Reviews patients' claims in EMR to ensure accurate coding and maintain compliant billing in accordance with Medicare, Medicaid, and federal research billing rules and industry regulations.
Manages post-award financial activities for industry and grant studies, overseeing funds and ensuring strict compliance with funding requirements inherent in our niche industry.
Compiles and analyze statistical, fiscal, contractual, labor productivity, and metric data related to clinical trial activities in compliance with industry standards for cross functional leadership. Generate comprehensive reports and provide detailed financial analysis, considering the unique regulations governing our specialized field.
Participates in special projects, quality improvement/assurance/control, and internal audits related to clinical trial finance and billing, ensuring timely invoicing, efficient cash flow management, and adherence to our industry's regulatory landscape.
Provides education, support, and clarification to research operations staff regarding research finance and billing processes, policies, and regulations specific to our niche industry.
Assists with policy and procedure development, both design and implementation, as they relate to compliance with laws, Medicare Coverage Analysis, National Coverage Determinations, statutes, and regulations dealing with clinical trial finance and billing issues.
Maintains the financial systems software and reporting capabilities in collaboration with other team members and outside vendors. Provide project management for system enhancements and/or system automation, expansions, and upgrades, communicating the impact to all research teams.
Qualifications
REQUIRED QUALIFICATIONS: Education: Bachelor’s degree in Biological/Life Sciences, Business Administration, Finance/Accounting, or other closely related field.
Experience: Three years healthcare, research (clinical and/or administration), general finance/accounting, and/or business administrative experience.
Other Skills/ Knowledge: Excellent interpersonal and communication skills Solid computer skills, including proficiency with microsoft software. Strong analytical and problem-solving skills, with the ability to be detail oriented. Proficient in Microsoft Office Suite. Demonstrated ability to gather, assemble, interpret, and use complex data to develop actionable steps that will improve processes and optimize results. General understanding of medical terminology. Demonstrated ability to train individuals and provide education to small groups. Team building and change management customer service.
PREFERRED QUALIFICATIONS: Experience: Research Administration and Regulations within our niche industry. Medicare Clinical Trial Policy, Medicare billing rules, Medicare Coverage Analysis within our specialized regulatory framework. Clinical trial budget development & negotiations. Research-related Electronic Medical Record (EMR) revenue cycle management. Research-related coding with a deep understanding of our industry’s coding standards. Accounts receivable and accounts payable experience. Service line profitability and margin reporting. Project Management/Strategic Planning Policy/Standard Operating Procedure/Working Process Writing/Maintenance. Experience in large, multicenter health system.
Licensure/ Certification: Any research-related certification
Other Skills/ Knowledge: Basic knowledge and understanding of the regulatory, operational, logistical, and administrative requirements of clinical research studies. Clinical Trial Management Systems (CTMS) and/or other research software systems. Basic knowledge of research regulations (e.g. IRB, FDA, OHRP, GCP, etc.)
OSF HealthCare is an Equal Opportunity Employer.