1. Responsible for identifying potential clinical research charges not specifically defined in research protocols. Researches and analyzes those charges by reading physician medical notes and reviewing research protocols, informed consent forms, and other associated documents. Makes determination as to whether each charge is research related and, if so, how it should be billed. 2. Oversees and resolves all clinical research charge activities for all clinical departments and/or sections. Provides continuous comprehensive, detailed analyses of findings that encompass claim submission and status, payment history, rejection analysis, frequency and status of unpaid clinical research claims via strict communication and on-going updates to department administration, physicians and coders. 3. Identify and advise on operational improvements to enhance efficiency of clean-claim submissions for prompt payment and overall reimbursement of clinical research services which will result in developing, implementing, and monitoring comprehensive policies and procedures for University-wide clinical research claims, invoicing and reimbursement. Functions as a resource and educator for clinical department physicians and all appropriate professional and research staff on clinical research billing, reimbursement and coding issues by department and disease. 4. Assists with the development of OnCore and Epic training and educational programs for clinical research billing while demonstrating project management skills to independently carry out projects as assigned or appropriate. Impeccable attention to detail with high level of accuracy. 5. Researches policies of payers and communicates changes as appropriate. Maintains regular interactions and communication with third party payers while ensuring compliance with University, governmental and all third party regulations, including claim submission, coding accuracy and documentation to support billing. Performs quality assurance processing and assesses degree of risk for non-compliance with internal audit findings.
Preferred Education: Working experience with CPT, HCPCS, ICD9, ICD10 certified and knowledge specific to research.
Preferred Education, Experience and Skills: Working experience with CPT, HCPCS, ICD9, ICD10 certified and knowledge specific to research.
Required Skill/ability 5: Extensive knowledge of Medicare and 3rd party carriers directly related to clinical research. Thorough knowledge of medical terminology, medical chart audits for research activity.
Posting Position Title: Research Charge Analyst
Required Skill/ability 3: Excellent organizational and analytical skills. Ability to function well with conflicting demands and deadlines. Well-developed planning, problem resolution and decision-making skills.
Work Week: Standard (M-F equal number of hours per day)
University Job Title: Research Charge Analyst
Required Skill/ability 1: Clinical research experience with proven understanding of study design and protocol development and analysis of fully executed clinical trial agreements. Proven ability to facilitate and manage complex medical billing and reimbursement processes.
Required Skill/ability 4: Proven ability to work successfully within a team environment and as an individual contributor. Outstanding interpersonal and teamwork skills and demonstrated professionalism in both verbal and written communication.
Required Skill/ability 2: Demonstrated project management skills to independently carry out projects as assigned or appropriate. Impeccable attention to detail with a high level of accuracy. Demonstrated proficiency with Microsoft applications: Excel, PowerPoint, Access, Word and experience with database management.
Bachelor's degree in a related field and one year of related work experience in the same job family or an equivalent combination of experience and education. Must be knowledgeable in regional and federal regulations with the ability to perform independent decision-making on a daily basis.
Internal Number: 60763BR
About Yale University
Yale University is an American private Ivy League research university located in New Haven, Connecticut. Founded in 1701 in the Colony of Connecticut, the university is the third-oldest institution of higher education in the United States.