Reporting to the Associate Director of the Yale Center for Clinical Investigations, this position will ensure the timely and efficient flow of clinical trial billing and reimbursement operations in a determined segment of School of Medicine departments. Updates appropriate procedures when discrepancies are found while working in collaboration with departmental study staff, Yale Center for Clinical Investigation, YNHH including HSR, Bridgeport and Greenwich, NEMG and Yale Medical Group. The position will be responsible for research and analysis of all complex, non-routine charges. This analysis requires a comprehensive understanding of research, research protocols, and associated documents as well as the ability to review and identify non-standard research charges in physician medical notes. A thorough and current knowledge of all related compliance issues is also critical to this work. This position will identify, research, and analyze information from all of these sources, make the determination as to whether a charge is research related and, if so, how it should be billed. In addition, compliance is a major responsibility for the central team especially with the system updates to Epic and OnCore. With the Yale commitment to be early adopters for any/all new versions, new applications and upgrades to Epic and OnCore, this central team will serve as the primary source for process improvement and enhancement recommendations with both vendors as well as across the Yale enterprise. This position will ensure compliance with protocol requirements, institutional billing compliance, and appropriateness of charges and reimbursement. Identifies workflow issues to allow resolution in a timely fashion to determine if charges represent clinical research services and distribute charges appropriately to financial responsible party with solid application of research specific modifiers and research specific code application. Develops and implements systems to support efficient billing and collection strategies to maximize income from clinical trial services and satisfy outstanding clinical research AR with efficiency and timeliness.
Posting Position Title: Research Charge Analyst
University Job Title: Clinical Research Analyst
Work Week: Standard (M-F equal number of hours per day)
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 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.
Required Skill/ability 3: Excellent organizational and analytical skills. Ability to function well with conflicting demands and deadlines. Well-developed planning, organizational, problem resolution and decision-making skills.
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 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.
Preferred Education, Experience and Skills: CPC and/or CPC-H with proven working knowledge, working experience with CPT, HCPCS, ICD9, ICD10 proficient and certified as well as knowledge specific to research.
Required Licenses Or Certifications:
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.
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.