CLINICAL TRIALS SPECIALIST at Duke University

Posted in Other 16 days ago.

Location: Durham, North Carolina





Job Description:



PRMO:, established in 2001, Patient Revenue Management Organization (PRMO) is a fully integrated, centralized revenue cycle organization supporting all of Duke Health, including Duke University Hospital, Duke Regional Hospital, Duke Raleigh Hospital, the Private Diagnostic Clinic, and Duke PrimaryCare. The PRMO focuses on streamlining the revenue cycle through enhanced management of scheduling, registration, coding, HIM operations, billing, collections, cash management, and customer service. The Mission of the PRMO is delivering quality service by enhancing the patient experience, providing financial security, and preserving Duke's reputation and mission of advancing health together. Our Vision is to be recognized as a world class innovative revenue cycle organization that values our people, patients and performance.




Job Summary:



Facilitate accurate billing for patients enrolled in clinical trials in accordance with federal regulations to reduce both institutional and individual provider legal and financial risk.




Job Responsibilities:




  • Ensure that charges associated with grants and clinical trials are billed appropriately for both physician and hospital services.

  • Diligently work reports and work queues to decrease bill hold accounts, and assist in communicating trends to reduce customer service issues/service now request

  • Assist in educating principal investigators-study teams regarding compliance with government regulations with special attention to CMS guidelines as they pertain to billing for patients enrolled in clinical trials.

  • Collaborate with physicians, business managers and clinical research coordinators in the development of improved capabilities in the areas of billing and compliance. Identify risk areas and implement corrective action.

  • Consistently document and notate to aid in enhancing education around identifying charges that are grant related or standard of care; resolving discrepancies in timely manner

  • Provide education to all clinical research staff on how to register patients for enrollment in trials and how to properly identify charges that are grant related versus standard of care.

  • Assist in the analysis and audit of processes and recommend changes and/or modifications to meet compliance and customer service goals

  • Create weekly reports for clinical research staff to review reducing customer service issues by correctly identifying charges that are appropriate i.e. insurance or grant related.

  • Facilitate communication between the clinical research coordinators and the CDM department to insure compliance with DUHS and SOM rules regarding uniform discounted fees for clinical trials.

  • Represent the PRMO in actively promoting initiatives with clinical faculty and administration.

  • Perform other related duties incidental to the work described herein





Qualifications at this position



Education:


High school diploma or equivalent is required, preferably supplemented by post-secondary courses in Accounting, Finance, Economics, Business Administration or a related field.




Experience:


Four years of related experience in healthcare is required
With preference in Clinical Trials/Research Billing and/or Patient Financial Services - Specialty Billing




Degrees, Licensure, and/or Certification:


A Bachelor's degree in a related field can substitute for the experience requirement.




Knowledge, Skills, and Abilities:


Working knowledge of medical vocabulary and terminology principles with an ability to apply in clinical trials billing operations


Proficient in MS Office, Word, EXCEL and data entry into EMR timely; allowing for efficient and accurate resolution of clinical trials issues


Ability to interpret federal regulations and research/clinical trials billing compliance guidelines


Actively participate in training sessions and evaluate effectiveness through improvements in quality control and audit results


System experience may include: Epic Resolute Hospital Billing, Epic Resolute Professional Billing and Epic CRM


Effective verbal and written communication skills



Data collection, reporting and analysis.



Duke is an Affirmative Action/Equal Opportunity Employer committed to providing employment opportunity without regard to an individual's age, color, disability, gender, gender expression, gender identity, genetic information, national origin, race, religion, sex, sexual orientation, or veteran status.

Duke aspires to create a community built on collaboration, innovation, creativity, and belonging. Our collective success depends on the robust exchange of ideas-an exchange that is best when the rich diversity of our perspectives, backgrounds, and experiences flourishes. To achieve this exchange, it is essential that all members of the community feel secure and welcome, that the contributions of all individuals are respected, and that all voices are heard. All members of our community have a responsibility to uphold these values.

Essential Physical Job Functions: Certain jobs at Duke University and Duke University Health System may include essentialjob functions that require specific physical and/or mental abilities. Additional information and provision for requests for reasonable accommodation will be provided by each hiring department.