Clinical Research Billing Specialist

Job Description

As a UW employee you have a unique opportunity to change lives on our campuses in our state and around the world. UW employees offer their boundless energy creative problem-solving skills and dedication to build stronger minds and a healthier world.

UW faculty and staff also enjoy outstanding benefits professional growth opportunities and unique resources in an environment noted for diversity intellectual excitement artistic pursuits and natural beauty.

UW Medicine works to improve the health of the public by advancing medical knowledge providing outstanding primary and specialty medical care to people of the region and preparing tomorrows physicians scientists and other health professionals. Within the large UW Medicine health system the School of Medicine (SOM) is a world leader in biomedical research with the largest biomedical research program at a public university based on National Institutes of Health funding and ranking among the top research universities internationally.

The Clinical Trials Office (CTO) supports the clinical research mission of UW Medicine. The CTO is an operational unit within the SOMs Office of Research and Graduate Education charged with providing multi-service support to clinical researchers bringing important new therapies to our patients in compliance with evolving regulatory requirements.

Position Purpose:

Clinical Research Billing Specialist position will enable the Clinical Research Billing Manager and Lead to coordinate and engage in the planning and implementation of new processes and systems without negatively impacting day-to-day unit management responsiveness to customer concerns proper training of new and existing members of the team and quality control of the units output. This position will provide appropriate handling of customer concerns possible due to the incumbents extensive experience. The role will assist in managing the significant change CRBB has undergone and will assist in planning for and accommodating the new work and work flows that will be outcomes of upcoming systems changes (e.g. CTMS Target 3 rollout). The Clinical Research Billing Specialist will:

• Support Billing team through day-to-day problem-solving in collaboration with or in the absence of Clinical Research Billing Manager and Lead;
• Maintain a partial portfolio of research billing review while managing unit work assignments and performing quality control review;
• Be a day-to-day resource to the Billing team; and
• Identify inconsistencies across the work product created by team members and recommend solutions in collaboration with colleagues and the units Manager and Lead

Position Complexities

This position is a specialist role for the institutional clinical research billing and revenue cycle management within the CTO Clinical Research Budget and Billing (CRBB) program. The position will require experience in systems complexity including OnCore and its interface with Epic understanding and operationalizing a billing grid and other systems designed to improve and enhance institutional and multi-institutional clinical research billing and post-award services and support. Ability to work collaboratively in a group setting in a fast-paced environment is crucial in this role.

Position Impact to the University

Clinical Trials Office is a central clinical research operation with compliance responsibilities and services across the vast portfolio of clinical trials in UW Medicine. The CTO operation has direct impact on UW reputation with major global biotech and biopharma sponsors the availability of funded clinical trial opportunities in UW pipeline and UW patients access to novel addition the CTO plays a key role in mitigating institutional financial and reputational risks by ensuring strict compliance with the CMS and the FDA regulations and guidelines. CTO Clinical Research Billing Team Lead is a key position in maintaining secure and fully compliant CTO operation.

Characteristic Duties and Responsibilities:

Epic Research Billing Workflows (30%)

• Research Billing Review:
  • Ensure charges routed according to study billing grid and in accordance with Epic charge documentation
  • Prioritize high-dollar and aging accounts
• Charge Review and Claim Edit: Ensure research charges/claims have required coding for billing
• No Rules and other escalations: Handle research billing questions escalated from Research Billing Coordinators and other departments

Epic Single Business Office (SBO) Research Invoicing Workflows (30%)

• Ensure timely generation of SBO invoices
• Receive and process invoice corrections including claims of missing charges
• Process invoice payments
• Follow up on aging research invoices to ensure payment

OnCore Clinical Trials Management System (CTMS)/Epic Interface (20%)

• Ensure accurate handoff from OnCore to Epic when study is activated or amended
• Ensure accurate handoff from OnCore to Epic when subject enrollment updated
• Perform Quality Control (QC) of study and enrollment records providing feedback to study teams as needed

Patient Claims Review (10%)

• Respond to questions regarding patients research study participation and the relationship to patient billing
• Escalate issues to Team Lead or Manager as appropriate

Medicare Rules: Application and Training (10%)

• Understand and exercise independent judgment and discretion in the interpretation and application of the Medicare National Coverage Determination for Routine Costs in Clinical Trials and all relevant UW Medicine clinical research budgeting and billing policies and procedures
• As needed provide training and education to Clinical Research Budget & Billing (CRBB) colleagues School of Medicine investigators research staff and practice site staff on research billing policies procedures and tools
• Provide excellent customer service and accurate guidance to clinical research study teams regarding clinical research billing policies and procedures
• Assist in development of content for CRBB website and outreach documents
• Assist faculty staff and others in interpreting internal and external research billing policies

Qualifications:

Required

• A Bachelors degree in science business healthcare administration or related field and at least two years related experience or equivalent combination of experience and education.

• Prior experience with Epic Resolute (Hospital and/or Professional Billing).
• Demonstrated team leadership skills. Ability to make positive contributions and work effectively and efficiently in a group environment.
• Exceptional customer service skills.
• Strong written and oral presentation skills. Ability to communicate effectively with all levels of staff faculty management and collaborators.
• Ability to understand and convey complex policy financial and scientific/technical information in a manner that is understandable to a wide audience.
• Ability to teach and mentor others in group settings in one-on-one sessions and remotely.
• Ability to prioritize and organize work independently in a fast-paced high-volume setting.
• Demonstrated skill in using Microsoft Excel and Access.

Desired

• Five years experience with healthcare and/or research billing clinical research study coordination or management health system operations or other related research or healthcare experience.
• Experience in an academic medical setting.
• Experience with Epics Research Billing module.
• Experience with a CTMS preferably OnCore.
• Accounting and finance experience.
• Knowledge of the Medicare Clinical Trials Policy and other federal state and institutional clinical research regulations.

Compensation Benefits and Position Details

Pay Range Minimum:

Pay Range Maximum:

Other Compensation:

Benefits:

Temporary or Regular

FTE (Full-Time Equivalent):

Union/Bargaining Unit:

About the UW

Working at the University of Washington provides a unique opportunity to change lives on our campuses in our state and around the world.

UW employees bring their boundless energy creative problem-solving skills and dedication to building stronger minds and a healthier return they enjoy outstanding benefits opportunities for professional growth and the chance to work in an environment known for its diversity intellectual excitement artistic pursuits and natural beauty.

Our Commitment

The University of Washington is committed to fostering an inclusive respectful and welcoming community for all. As an equal opportunity employer the University considers applicants for employment without regard to race color creed religion national origin citizenship sex pregnancy age marital status sexual orientation gender identity or expression genetic information disability or veteran status consistent with UW Executive Order No. 81.

To request disability accommodation in the application process contact the Disability Services Office at or .

Applicants considered for this position will be required to disclose if they are the subject of any substantiated findings or current investigations related to sexual misconduct at their current employment and past employment. Disclosure is required under Washington state law.