Research and Institutional Billing Lead

Title: Research & Institutional Billing Lead

Location: Pittsburgh United States

Job ID: 8266557337
Status: Full-Time
Regular/Temporary: Regular
Shift: Day Job
Work Arrangement: Remote
Facility: Corporate Revenue Cycle
Department: Rev Cyc Charge Mgmt
Union Position: No
Salary Range: $ 21.14-35.13 USD

Job Description:

Purpose:
Do you have experience with reimbursements?  Do you have research and institutional billing experience?  UPMC is looking to hire a full-time Research and Institutional Billing Lead.  This position would work Monday through Friday during daylight hours and is eligible to work remotely, with occasional on-site work at the Quantum One Building as needed.

This position functions as a Lead to facilitate the appropriate billing and prompt/correct reimbursement for all monies owed by third parties. The Research and Institutional Billing Lead monitors the auditing of research requisitions to ensure proper billing of research related services, coordinates the billing process within the Health Services Division, and identifies inefficiencies. Additionally, the Lead monitors the institutional accounts to ensure appropriate registration and reimbursement validation, and they monitor high dollar/aged accounts receivable to ensure collectability.

If you have research and institutional experience and are ready to grow your career, apply today!

Responsibilities:

• Refrain from disclosing or revealing confidential information to any person and do not access patient or coworker records (either electronic or files) except as specifically necessary to perform job duties.
• Document appropriate account activity and comment codes in respective billing system.
• Collate monthly invoice statements, retrieve and file folders as well as submission of monthly statements via e-mail or US mail for reimbursement.
• Obtain research requisitions and document accordingly.
• Monitor accounts receivable to facilitate the prompt resolution of accounts or issues with involved parties including the Revenue Cycle, Hospital Departments and outside entities.
• Follow up status calls to institutional contact for payment.
• Assist in establishing goals to reduce the AR, improve cash collections and accounts receivable aging.
• Perform account analysis on problematic/aged accounts.
• Provide recommendations to develop process improvements relative to research and institutional billing/collections.
• Function as a liaison between research coordinators, research principal investigators, Compliance and the Revenue Cycle.
• Responsible for Bad Debt process/Agency placements.
• Ensure compliant billing guidelines for Medicare Qualifying Trial and Investigational Device Clinical Trials.
• Register Institutional/Research professional and facility accounts in the Billing System.
• Review monthly institutional statements for accuracy, and make any necessary charge transfers or adjustments as well as contact to distribute bulk payments on institutional accounts to the specific charge transactions.
• Prepare/process facility intercompany journal entries.
• Upon request, provide all applicable rates for clinical trials and other requests.
• Provide education and training to increase awareness of Research billing regulations focusing on Medicare/payer guidelines, also including the use of institutional accounts. Assist in the development of policies and procedures.
• Support Revenue Cycle areas to ensure compliance of all revenue cycle protocols.
• Responsible for monthly professional research Sox controls and Epic Custom Menu maintenance.
• Perform all duties and responsibilities according to the philosophy and standards of UPMC, embracing the system-wide core competencies.
• Adhere to the UPMC and Revenue Cycle Standards of Conduct.
• Review corporate Fiscal Review form to confirm accuracy.
• Support and contribute to UPMC core values and guiding principles and abide by all UPMC departmental policies, procedures and goals in the process of performing job responsibilities.
• Incorporates acts of dignity and respect in daily interactions.

Qualifications:

• High School or equivalent and 4 years of healthcare billing experience incluidng 2 years previous institutional billing experience or 6 years of research related operations experience required.
• Bachelor’s degree preferred.
• 2-4 years data entry experience.
• Keyboard dexterity and accuracy.Knowledge of medical terminology, iCD-9 and CPT coding preferred.
• Detail oriented individual with excellent organizational, interpersonal and communication skills.
• Knowledge of MS Office products.
• Ability to maintain designated quality and production standards.
• Proficiency in MS Office/PC skills preferred.

Licensure, Certifications, and Clearances:

• Act 34