- Performs review of all technical and professional charges generated from EPIC and any ancillary subsystems for allocation to the research study account, insurance claim and/or patient statement to verify the accuracy of charges as they compare to the research billing intention/plan outlined in the protocol Billing Grid.
- Performs remediation of charge errors discovered during EPIC review.
- Identifies appropriate use of billing modifiers and other CMS requirements for billing research-related charges to federal and non-federal payors.
- Verifies and resolves discrepancies by utilizing the tools and resources available, e.g., EPIC billing system, OnCore (clinical trial management system), medical record documentation, Charge Master data, Patient Accounting/VMG Business Offices and/or contacting study personnel in the appropriate internal department.
- Remains knowledgeable about CMS and Fiscal Intermediary medical necessity guidelines and their impact on billing and reimbursement in clinical research.
- Collaborates with the clinical research department administrators and study coordinators in the development and implementation of educational activities related to charge capture improvement projects.
- Supply all missing information and correct inaccurate data as needed.
- Processes charge related corrections/additions/removals in EPIC for both the hospital and physician billing to ensure organizational compliance with all state and federal regulations.
- Calculates and facilitates the refunding of inappropriate reimbursement in collaboration with WFBMC Financial Services. Responsible for the movement of funds and correction of fees in EPIC.
- Follows established hospital and physician departmental guidelines and state and federal regulations to assure the most productive and compliant outcome when processing charge related corrections.
- Perform specialized duties involved in the preparation and processing of particularly complex charge issues.
- Audit and review accounts to ensure accuracy; investigate and correct errors, follow-up on missing account information, and resolve past due accounts.
- Identify insurance issues that need to be forwarded and addressed by the appropriate insurance teams. Report issues to the appropriate supervisor as needed.
- Prioritizes job tasks; demonstrates willingness to assist Manager/Director in the completion of special projects and daily task to support the Department's productivity and efficiency.
- Demonstrates responsibility for personal development by participating in continuing education offerings.
- Performs other related duties incidental to work described herein.
-
Billing Reviewer II
6 days ago
Atrium Health Charlotte, United StatesOverview · JOB SUMMARY: · The Clinical Research Billing Reviewer II is a position that resides in the Office of Clinical Research (OCR). Under the direction of the Manager, Clinical Research Billing Review the position is a mid-level performer of charge capture and claim resolut ...
-
Billing Reviewer II
1 week ago
Atrium Health Charlotte, United States Full timeOverview · JOB SUMMARY: The Clinical Research Billing Reviewer II is a position that resides in the Office of Clinical Research (OCR). Under the direction of the Manager, Clinical Research Billing Review the position is a mid-level performer of charge capture and claim resolutio ...
-
Director of Specialty Bill Review Services
6 days ago
Rising Medical Solutions Charlotte, United StatesAs our Director of Specialty Bill Review Services, you will maximize savings and client satisfaction by providing strategic direction for Rising's Specialty Services unit involving complex/large medical claims; analyzing and optimizing bill review procedures and systems; and lead ...
-
Medical Assistant
6 days ago
Charlotte Community Health Clinic Charlotte, United States**Job Summary**: · The medical assistant will assist providers in examination and treatment of patients in an outpatient clinical facility. Prepare treatment rooms, position instruments and equipment, as needed per chief complaint. Operate medical equipment, give injections and/o ...
-
Buyer / Planner (Materials)
1 week ago
Supply Technologies Charlotte, United StatesWe are hiring at Supply Technologies, a subsidiary of ParkOhio(NASDAQ:PKOH), specializes in supplier selection and management, planning, implementing, managing the physical flow of product for world-class international manufacturing companies, and servicing customers in the vario ...
-
Sup, Customer Service
4 days ago
Spectrum Charlotte, United StatesThis position is responsible for the coaching and development of a team of call center representatives in a fast-paced, dynamic call center environment. This supervisor is responsible for leading and providing feedback to aid representatives in accomplishing their key measures of ...
-
Personal Property Appraiser I/ii
6 days ago
Gaston County Government Gastonia, United StatesThe duties listed below are not all of the duties that may be assigned but are those that are considered as essential for an employee to perform. · - Assists the public by explaining NC State Property Tax Laws. Advises of actual or potential tax liability and procedures for listi ...
-
Post-Award Finance Coordinator
2 weeks ago
Atrium Health Charlotte, United States Full timeOverview · Job Summary: · Under limited direction, will independently collaborate with investigators, scientific, and administrative staff members to coordinate the management of grant & clinical trial-related expenditures and financial transactions, including grant/clinical tri ...
-
Coding Reimbursement Specialist
6 days ago
Atrium Health Charlotte, United States Full timeOverview · Job Summary · Performs assignment of ICD and CPT codes in cases of low to intermediate complexity. · Essential Functions · Performs ICD and CPT coding of provider (professional) services and verifies that all requisite charge information is entered. · Appends limited ...
-
Pharmacy Buyer Levine Cancer Institute FT
3 weeks ago
Atrium Health Charlotte, United States Full timeOverview · Job Summary · Purchases pharmaceuticals, controlled substances and related supplies and is responsible for all activities related to the procurement, receipt, storage, and return of all pharmaceuticals and supplies. · Essential Functions · Oversees and is responsible ...
-
Reimbursement Specialist
6 days ago
Metrolina Nephrology Associates Charlotte, United States: · Metrolina has competitive wages and benefits and a generous paid time off package beginning in your first year of employment: 4 weeks (accrued) paid time off PLUS 7 additional paid holidays We also have a generous 401k plan with two entry points during the year. · Metrolina N ...
-
Reimbursement Specialist
4 days ago
Metrolina Nephrology Associates Charlotte, United States: · Metrolina has competitive wages and benefits and a generous paid time off package beginning in your first year of employment: 4 weeks (accrued) paid time off PLUS 7 additional paid holidays We also have a generous 401k plan with two entry points during the year. · Metrolina N ...
-
Lead Clinical Quality Coder
1 week ago
Atrium Health Charlotte, United StatesJob Summary · Trains team members and performs coding audits. Reviews clinical documentation and diagnostic results as appropriate to extract data and apply appropriate ICD9/10-CM and CPT 4 codes for billing internal and external reporting, research and regulatory compliance. Ass ...
-
Senior Revenue Analyst
1 week ago
Brookfield Renewable Charlotte, United StatesOverview · Responsible for revenue and settlement functions for Deriva Energy wind and solar portfolio. Job duties include analyzing information from internal and external sources, reading and interpreting contract terms, reconciling and validating settlement data, completing mo ...
-
Billing Client Support Specialist
1 week ago
TalentBridge Charlotte, United StatesTalentBridge, a leader in the professional recruiting industry, is seeking candidates to work as a Billing Client Support Specialist. · Job Description: · Partner with clients to give status updates on requested move, add or change (MAC) activities, for Enterprise product types ...
-
Medical Biller/Coder
1 week ago
The C.W. Williams Community Health Center, Inc. Charlotte, United States Full timeThe C.W. Williams Community Health Center, Inc. is expanding and seeking an experienced Medical Biller/Coder to join our finance team. · The ideal candidate will have a strong background in medical billing and coding with the skills necessary to improve our billing and coding pro ...
-
Medical Biller/Coder
1 week ago
The C.W. Williams Community Health Center, Inc. Charlotte, United States Full timeThe C.W. Williams Community Health Center, Inc. is expanding and seeking an experienced Medical Biller/Coder to join our finance team. · The ideal candidate will have a strong background in medical billing and coding with the skills necessary to improve our billing and coding pro ...
-
Duck Creek
4 weeks ago
Cognizant Technology Solutions Charlotte, United States OTHERAbout Cognizant: · Cognizant (Nasdaq-100: CTSH) is one of the world's leading professional services companies, transforming clients' business, operating and technology models for the digital era. Our unique industry-based, consultative approach helps clients envision, build and r ...
-
Infusion Reimbursement Manager
6 days ago
Prochant Charlotte, United StatesProchant is seeking an InfusionReimbursement Manager to work remotely. The Infusion Reimbursement Manager is responsible for managing the billing and collection function for all payer groups including Medicare / Medicaid. Responsible for escalating billing and/or collection issue ...
-
Insurance Collector
1 week ago
Women's Health CT Rocky Hill, United States**Women's Health CT**, a proud affiliate of Unified Women's Healthcare, is seeking an experienced medical Insurance Collector to join our Central Billing team (CBO). · This is a hybrid work arrangement requiring one to two days in the office located in Rocky Hill, CT and the rema ...
Billing Reviewer II - Charlotte, United States - Atrium Health
Description
JOB SUMMARY:
The Clinical Research Billing Reviewer II is a position that resides in the Office of Clinical Research (OCR).
Under the direction of the Manager, Clinical Research Billing Review the position is a mid-level performer of charge capture and claim resolution in Epic (electronic health record and patient billing system) for clinical research studies across all regions of the Atrium Enterprise.
The position is responsible for performing line-item charge review of research patient encounters in the Atrium Health charge capture system, EPIC.
The position will assure the accuracy and completeness of all assigned charges linked to research in EPIC and captured in EPIC for study sponsor or insurance/patient billing of inpatient and outpatient hospital services for research participants.
Clinical research billing reviewer activities include but are not limited to the review and allocation of research charges in EPIC.
EXPERIENCE:
High School Diploma or GED required; Associates Degree preferred. Minimum of 2 years related coding/reimbursement experience required. Medical terminology, knowledge of accounts payable and receivable processes preferred. Minimum of 3 years business office experience in a healthcare environment or Research Office experience preferred.
LICENSURE, CERTIFICATION, and/or
REGISTRATION:
CPC or RHIT certification required.
ESSENTIAL FUNCTIONS:
SKILLS/QUALIFICATIONS:
Excellent oral and written communication skills. Excellent phone etiquette and internal/external customer service skills, required.
Strong interpersonal skills and attention to detail.
Experience with computerized databases (e.g., Microsoft Excel), word processing (e.g., Microsoft Word), and presentation software (e.g., Microsoft PowerPoint).
Demonstrates ability to work independently.
WORK ENVIRONMENT:
Clean, comfortable, well-lit, office environment.
