University of Chicago (UC)
Associate Director, Research Billing Compliance
University of Chicago (UC), Chicago, Illinois, United States, 60290
Location: Chicago, IL
Job Description:
Oversee day to day operations of all aspects of the charge review process within the Clinical Research Revenue Cycle and provide oversight to Clinical Research Billing Compliance team.
Institutional Subject Matter expert for Research billing workflows; provides guidance on research billing regulations and best practices.
Creates opportunities for research billing training for research investigators and staff; leads development and design of training and guidance materials related to research billing and financial management in collaboration with CTFG & OCR training & education.
Perform and oversee internal quality assurance & audits of research accounts to ensure billing compliance, coordinate research billing audits with Internal Audit team for the financial audit process for compliant research billing.
Maintain Institutional Research Charge Master and provide research staff with codes, costs, and fees to construct study budgets.
Generates Epic and CTMS reports for analysis, monitoring and improving research billing metrics and processes.
Effectively collaborates with Clinical Trial Financial Group, Hospital Revenue Cycle team, study teams, research subjects, IRB, and other stakeholders to address research billing challenges.
Ensure institutional research billing compliance with Medicare's Clinical Trial Policy, federal regulations, and contractual agreements. Maintain a detailed understanding of Medicare's Clinical Trial Policy (NCD 310.1) and related guidance documents.
Develop and maintain policies, SOPs & SOWs related to clinical research billing process.
Stays current on all internal processes related to research billing, Medicare, National and local regulations and guidelines, policies and procedures governing Research billing.
Manages the day-to-day activities of the Clinical Revenue support staff.
Maintains departmental compliance efforts by participating in training sessions, performing audits, and promoting an understanding of procedures, policies, and expectations.
Performs other related work as needed.
Preferred Qualifications Education: Advanced Degree in related field, strongly preferred.
Experience: 5-7 years experience with healthcare clinical research billing, clinical research management, health system operations, strongly preferred.
Experience in an academic medical setting strongly preferred.
Experience with Epic's Research Billing module strongly preferred.
Experience with a Clinical Trial Management system (CTMS) preferably OnCore, financial software, ERP systems, strongly preferred.
Accounting and finance experience, strongly preferred.
Licenses and Certifications: Coding certification (AAPC or AHIMA) strongly preferred.
Research compliance certification strongly preferred.
Epic research billing certification strongly preferred.
OnCore CTMS experience strongly preferred.
Preferred Competencies Knowledge of the Medicare Clinical Trials Policy and other federal, state and institutional clinical research regulations.
Expertise in CPT, Modifiers, ICD, and PCS codes to support billing and compliance efforts.
Strong knowledge of clinical trial contracting, revenue recognition principles, and relevant regulatory guidelines (e.g., ICH-GCP).
Excellent attention to detail and analytical skills, with a focus on accuracy in financial operations.
Strong communication and interpersonal skills for effective collaboration with cross-functional teams and external partners.
Leadership skills and experience in managing, mentoring or guiding junior team members.
Working Conditions Office Environment.
Application Documents Resume (required)
Cover Letter (preferred)
#J-18808-Ljbffr
Institutional Subject Matter expert for Research billing workflows; provides guidance on research billing regulations and best practices.
Creates opportunities for research billing training for research investigators and staff; leads development and design of training and guidance materials related to research billing and financial management in collaboration with CTFG & OCR training & education.
Perform and oversee internal quality assurance & audits of research accounts to ensure billing compliance, coordinate research billing audits with Internal Audit team for the financial audit process for compliant research billing.
Maintain Institutional Research Charge Master and provide research staff with codes, costs, and fees to construct study budgets.
Generates Epic and CTMS reports for analysis, monitoring and improving research billing metrics and processes.
Effectively collaborates with Clinical Trial Financial Group, Hospital Revenue Cycle team, study teams, research subjects, IRB, and other stakeholders to address research billing challenges.
Ensure institutional research billing compliance with Medicare's Clinical Trial Policy, federal regulations, and contractual agreements. Maintain a detailed understanding of Medicare's Clinical Trial Policy (NCD 310.1) and related guidance documents.
Develop and maintain policies, SOPs & SOWs related to clinical research billing process.
Stays current on all internal processes related to research billing, Medicare, National and local regulations and guidelines, policies and procedures governing Research billing.
Manages the day-to-day activities of the Clinical Revenue support staff.
Maintains departmental compliance efforts by participating in training sessions, performing audits, and promoting an understanding of procedures, policies, and expectations.
Performs other related work as needed.
Preferred Qualifications Education: Advanced Degree in related field, strongly preferred.
Experience: 5-7 years experience with healthcare clinical research billing, clinical research management, health system operations, strongly preferred.
Experience in an academic medical setting strongly preferred.
Experience with Epic's Research Billing module strongly preferred.
Experience with a Clinical Trial Management system (CTMS) preferably OnCore, financial software, ERP systems, strongly preferred.
Accounting and finance experience, strongly preferred.
Licenses and Certifications: Coding certification (AAPC or AHIMA) strongly preferred.
Research compliance certification strongly preferred.
Epic research billing certification strongly preferred.
OnCore CTMS experience strongly preferred.
Preferred Competencies Knowledge of the Medicare Clinical Trials Policy and other federal, state and institutional clinical research regulations.
Expertise in CPT, Modifiers, ICD, and PCS codes to support billing and compliance efforts.
Strong knowledge of clinical trial contracting, revenue recognition principles, and relevant regulatory guidelines (e.g., ICH-GCP).
Excellent attention to detail and analytical skills, with a focus on accuracy in financial operations.
Strong communication and interpersonal skills for effective collaboration with cross-functional teams and external partners.
Leadership skills and experience in managing, mentoring or guiding junior team members.
Working Conditions Office Environment.
Application Documents Resume (required)
Cover Letter (preferred)
#J-18808-Ljbffr