Posted: 5/27/2022
The Research department is critical to the work of Oregon Oncology Specialists because we are able to offer our patients access to novel therapies and opportunities that are unavailable outside of a clinical trial. We do this by initiating clinical trials which address the top 5 tumor sites, offering enrollment to eligible patients, and once enrolled, coordinating every aspect of the clinical trial. Our patients are closely monitored for any changes, while preventing and optimally managing any toxicities and facilitating ongoing trial participation.
Oregon Oncology has a unique opening for a Research Compliance Analyst to join our practice.
Position Overview
The Research Compliance Analyst is key to the success of our Research and Revenue Cycle departments because they foster a culture of research billing compliance and compliant research finance workflows which support sustainable research at Oregon Oncology Specialists. This person serves as subject matter expert in the research revenue cycle and coverage analysis, payer coverage roles, coding requirements, the Medicare clinical trial policy, IND and IDE study billing rules, and related state and federal regulations to execute correct billing designations.
Essential Job Functions
- Ensures all charges for facility and professional fees arising from clinical study protocol visit items and services are consistently segregated and billed to the appropriate payer, submitted on correct claims with proper research codes, modifiers in NCT number, and properly reimbursed, avoiding denials and mitigating risk of double billing to both a study sponsor and a third-party payer (insurer)
- Interacts routinely with research team and serves as a liaison between the revenue cycle department and the research department
- Works the claim: Identifies responsible party by examining patient record, coverage analysis and billing grid, segregate all relevant claims/charges based on the study coverage analysis; applies codes and modifiers as appropriate.
- Works with accounting department to generate and submit complete and accurate research related invoices to study sponsors; monitors and analyzes unresolved patient accounts; initiates contacts and appropriate resolution to ensure timely and maximum allowed payment.
- Provides billing information by collecting, analyzing, and summarizing third-party billings, accounts pending, and late charges data and trends
- Creates special reports he manages special projects as assigned
- Completes other related duties as assigned in order to meet the goal of the department and organization
- Serves as subject matter expert in the research revenue cycle and coverage analysis, payer coverage roles, coding requirements, the Medicare clinical trial policy, IND and IDE study billing rules, and related state and federal regulations to execute correct billing designations
Required Qualifications
- Bachelor’s degree in Health Informatics, Health Information Management, Accounting or similar
- Experience working with government and commercial payer sources, coding and billing
- Basic coding knowledge: Medical terminology, CPT, CPT 2, ICD 10–CM and HCPCS level II coding
- Proficient in Microsoft office software including word, Excel, and PowerPoint
- Superior customer service, communication and organizational skills
REQUIRED LICENSURE/ CERTIFICATION/ REGISTRATION
- ICD–10 and CPT coding certification
Preferred Qualifications
- Strong analytical skills
- Highly attentive to details
- Working knowledge of local and federal rules and regulations
- Experience working with complex clinical trials/ clinical research program
A successful Research Administrator will….
- Enjoy being detailed oriented
- Develop workflows, processes and procedures to support research billing compliance
- Create and maintain relationships with the Research team, Revenue cycle team and sponsors/ CROs
- Possess desire to engage in continued learning and adaptation to rules and regulations governing study conduct
- Maintain integrity and confidentiality
- Understand how clinical research is an integral part of OOS
Job Type
Full-time
Pay
From $70,000.00 per year
COVID-19 considerations:
OOS is committed to the health and safety of our patients, visitors and employees. PPE is provided and sanitation measures are in place to ensure the safest environment possible.
To Apply:
Email Careers@orcancer.com with the job title in the subject line, and attach your cover letter and resume.
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OOS is an Equal Opportunity Employer:
Oregon Oncology provides equal employment opportunities to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability or genetics. In addition to federal law requirements, Company complies with applicable state and local laws governing nondiscrimination in employment in every location in which the Company has facilities.