Location: Gainesville,FL, USA
Overview:
Ensures the financial integrity of UF Health - Shands Hospital and UF Health Physicians Billing and Accounts receivables by reviewing pre-billed, billed and denied charges related to Clinical Trials, Investigational Device Exemption (IDE) Studies, and Clinical Studies Approved under Coverage with Evidence Development (CED), research and grants. Review and research clinical documentation, coding, encounter details and line item charges to distinguish between research-related and non-research-related activity. Assure timely, efficient and accurate completion of research billing related edits for clean claim billing and re-billing. Ensure accurate, timely billing and collection of research study funded hospital and professional services performed. Make recommendations and take actions to improve research billing compliance structure, system or outcomes. Be a vital resource for a diverse group of internal and external professionals. Maintain professional standards; following the AHIMA/AAPC professional code of ethics.
When performing as a Lead Research Billing Analyst, the position is responsible for team support by providing quality and efficient customer service through the daily management of the team including: coaching and training, motivating, recognizing and rewarding, and problem solving. Be a vital resource to a diverse group of internal and external professionals with questions and concerns related to Clinical Trials, Investigational Device Exemption (IDE) Studies, and Clinical Studies Approved under Coverage with Evidence Development (CED), research and grants. Performs necessary account research, balance verification, customer support, and verification of that appropriate research billing policies and procedures are followed. Responsible for all activity related to research billing and collection. Make recommendations and take actions to improve research billing compliance structure, system or outcomes to maximize collections. Must use independent judgment on the prioritization of assigned tasks.
Qualifications:
Minimum Education and Experience Requirements:
?High school diploma or equivalent. Bachelor?s or Associates degree preferred, or equivalent experience 3-5 year?s healthcare billing/collections.
?Two years of healthcare/billing and collections/financial experience required. Knowledge of research billing compliance regulations and federal/managed care billing and payment rules preferred.
?CCS, CCS ? P, CPC ? H or CPC required (or obtained within one year of employment).
?Knowledge of medical terminology required and knowledge of human anatomy and physiology preferred.
?Knowledge of Charge Description Master (CDM) and Physician/Hospital fee schedules preferred.
?Excellent communication, organization and problem-solving skills required. Incumbent must be comfortable discussing billing and charging matters with a diverse group of internal and external professionals.
?The ability to interpret and apply analytical criteria when researching, analyzing and resolving research billing, claims and customer service/collections issues are necessary attributes of the successful incumbent.
?The ability to multi-task, prioritize responsibilities and achieve successful outcomes in a team environment are necessary.
?Candidate must be well organized, self-motivating, versatile and able to work independently.
?Position requires exposure to and protection of confidential and sensitive information.
?Must be able to perform under high levels of stress and be comfortable discussing issues and providing Epic Research Module workflow feedback in a professional manner.
Motor Vehicle Operator Designation:
Employees in this position:
Will not operate vehicles for an assigned business purpose
NOTE: A frequent driver is defined as one who uses his/her personal or Shands automobile
a) at least once daily, b) at least five individual trips per week or c) drives, on average, over 150 miles per week in the performance of his/her job.
Licensure/Certification/Registration:
None