Clin Trials Rsch Coverage Analyst

Location:

Chicago, Illinois
Business Unit:
Rush Medical Center
Hospital:
Rush University Medical Center
Department:
Research Billing Support
Work Type:
Full Time (Total FTE between 0.9 and 1.0)

Shift: Shift 1

Work Schedule:

8 Hr (8:30:00 AM - 5:00:00 PM)
Rush offers exceptional rewards and benefits learn more at our Rush benefits page (https://(Use the "Apply for this Job" box below).).
Pay Range: $29.36 - $47.79 per hour
Rush salaries are determined by many factors including, but not limited to, education, job-related experience and skills, as well as internal equity and industry specific market data. The pay range for each role reflects Rush’s anticipated wage or salary reasonably expected to be offered for the position. Offers may vary depending on the circumstances of each case.

Reporting to the Director/Manager of Clinical Trials Research Revenue Cycle, this position will create coverage analyses in accordance with Medicare's Clinical Trial Policy (NCD 310.1) and assist research staff within the clinical departments with the interpretation of related guidance and their effect on research billing processes. The analyst will provide high-level professional support in the growing efforts to conduct prospective Medicare Coverage Analysis for all clinical research studies.

Exemplifies the Rush mission, vision and values and acts in accordance with Rush policies and procedures.

Experience/Qualifications/

Competencies:

• Bachelor's Degree in a health-related discipline, e.g. pharmacology, nursing, biology (Four years of additional work experience in lieu of bachelor's experience).
• One to five years of coding experience
• AAPC or AHIMA certification in coding within one year of hire with experience in research medical billing and coding. Certifications may include Certified Professional Coder (CPC), Certified Coding Specialist (CCS) and Certified Medical Coder (CMC), and any other specialized coding certification approved by the two main governing bodies.
• Proficiency with medical terminology as well as medical research billing language. Must demonstrate a thorough knowledge of the three code sets that are currently in use:
  Current Procedural Terminology (CPT), ICD-10-CM, and Healthcare Common Procedure Coding System (HCPCS) Level II.
• Excellent written and oral communication skills.
• Strong investigative skills.
• Proficiency with MS Excel tables, formatting and basic calculations.
• Demonstrated resourcefulness and attention to detail.
• Able to work in a team environment and maintain a positive outlook.
• Able to learn and apply technical knowledge in the areas of clinical research, medical coding and revenue cycle in a consultative manner.
• Excellent verbal and written communication skills due to direct interaction with senior management.
• Strong time management and organizational skills with the ability to effectively multi-task and meet deadlines.
• Strong problem solving and financial analytical skills. High degree of accuracy for analyses and processes.
• Must have a strong customer service focus.

• Familiarity with different types of clinical research and the drug development process.
• Understanding of FDA regulations related to clinical trials involving investigational New Drugs (INDs) and/or investigational Device Exemptions (IDEs).
• Knowledge of Medicare coverage decisions, benefit policy manuals and billing processes.
• Previous experience in Research Billing, Budgeting/ budgeting analysis for Research Clinical Trials, Coverage Analysis, or other Research Finance background.

• Maintain a detailed understanding of Medicare's Clinical Trial Policy (NCD 310.1) and related guidance documents.
• Generate detailed and accurate coverage analyses with budget overlay in a timely manner.
• Review clinical trial protocols and related regulatory documents to prepare a billing plan for all medical procedures and services required in a clinical research project.
• Review clinical research protocols and determine which procedures are routine, and therefore billable to Medicare and other third-party payers based on CMS policy and National and Local Coverage Determinations, as well as…