We’re looking for a Research Billing Compliance Analyst, someone who’s ready to grow with our company. In this position, you’ll be responsible for reviewing and processing clinical research billing activities for clinical trials and other clinical research studies. This role tracks and reviews clinical research billing grids and reviews pre-billed and billed charges related to clinical research. This role interacts with clinical research study teams, IS-EPIC, and other team members to reduce the risk of inappropriately billing patients and/or third parties for research related services/procedures.
Think you’ve got what it takes?
Job Duties & Responsibilities
Communicates effectively across various teams, including Clinical Trial Managers, Office of IRB, Academic Office of Clinical Research, Grants and Contracts, Internal Audit, Institutional Billing, and Hospital Finance
Receives initial protocol packages from Principal Investigators
May attend feasibility meetings
Communicates with the Principal Investigator, research nurses, and study coordinators to discuss study design and determine which items are standard of care versus research care
Works closely with Senior Billing Compliance Analysts and BCM’s Office of Research to ensure the accuracy of billing grids
Completes timely pricing quotes for clinical trials and studies conducted at TCH within institutional and Medicare guidelines
Collects financial data (both manually and automatically) from several institutional databases and systems
Uses spreadsheets and database software to analyze charge, cost, and collection data for patients participating in clinical trials
Prepares monthly statements and invoices for review and payment by the Principal Investigator for clinical research charges per study
Maintains spreadsheets of study accounts and write-offs sent to Financial Services and Patient Accounting for institutional processing and tracking
Maintains and updates clinical trials in the Epic system (online medical record system)
Processes and reviews clinical research charges in Epic for both technical and professional charges
Accesses institutional charge masters to provide pricing for procedures using both SIMS and CPT codes
Accesses BRAIN to ensure the accuracy of IRB protocol information and verify approval
Accesses the Clinical Trials Management System (CTMS) to ensure appropriate billing modifiers are used on billing grids
Conducts clinical research billing audits of study records upon request or as needed.
Participates in cross-training with other staff on the Research Billing Compliance team
Learns FDA device regulations, CMS billing guidelines, and appropriate billing rules for various populations
Conducts and completes special projects as assigned and defined by the Assistant Director and/or Director within established timelines determined at project inception and by project participants and circumstances
Develops budgets for sponsors
Skills & Requirements
Bachelor's Degree Business or Hospital Administration or a related field required
CPC — Certified Professional Coder, American Academy of Professional Coders preferred
RHIA — Registered Health Information Administrator, American Health Information Management Association preferred
RHIT — Registered Health Information Technician, American Health Information Management Association preferred
CCRP — Certified Clinical Research Professional, Society of Clinical Research Associates preferred
CRA — Certified Research Administrator, Research Administrators Certification Council preferred
1 year Experience in research, billing, compliance, finance or Health Care Administration preferred
Familiarity with clinical trial study design, coordination and/or management preferred
Since 1954, Texas Children’s has been leading the charge in patient care, education and research to accelerate health care for children and women around the world. When you love what you do, it truly shows in the smiles of our patient families, employees and our numerous accolades such as being consistently ranked as the best children’s hospital in Texas, and among the top in the nation by U.S. News & World Report as well as recognition from Houston Business Journal as one of this city’s Best Places to Work for ten consecutive years.
Texas Children’s comprehensive health care network includes our primary hospital in the Texas Medical Center with expertise in over 40 pediatric subspecialties; the Jan and Dan Duncan Neurological Research Institute (NRI); the Feigin Tower for pediatric research; Texas Children ’s Pavilion for Women, a comprehensive obstetrics/gynecology facility focusing on high-risk births; Texas Children ’s Hospital West Campus, a community hospital in suburban West Houston; Texas Children ’s Hospital The Woodlands, the first hospital devoted to children ’s care for communities north of Houston; and Texas Children’s Hospital North Austin, the new state-of-the-art facility providing world-class pediatric and maternal care to Austin and Central Texas families. We have also created Texas Children ’s Health Plan, the nation ’s first HMO focused on children; Texas Children ’s Pediatrics, the largest pediatric primary care network in the country; Texas Children ’s Urgent Care clinics that specialize in after-hours care tailored specifically for children; and a global health program that is channeling care to children and women all over the world. Texas Children ’s Hospital is affiliated with Baylor College of Medicine, one of the largest, most diverse and successful pediatric programs in the nation.
To join our community of 15,000+ dedicated team members, visit texaschildrenspeople.org for career opportunities.
Texas Children’s is proud to be an equal opportunity employer. All applicants and employees are considered and evaluated for positions at Texas Children's without regard to mental or physical disability, race, color, religion, gender, national origin, age, genetic information, military or veteran status, sexual orientation, gender identity, marital status or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.
Texas Children’s Hospital is a world-class pediatric facility, nationally recognized as a top children’s hospital, and voted one of the best places to work in Houston for nine years running. We’re committed to creating a healthy community for children by providing the best pediatric care possible, through groundbreaking research and emphasis on education. We also offer a full continuum of family-centered care for women, from obstetrics to well-woman care. As a team member at Texas Children’s Hospital, you’ll work in an environment that values your voice. Texas Children's Hospital, headquartered in Houston, Texas, is recognized as one of America's best children's hospitals.
