Job Summary: Processes non-industry sponsored claims and all professional fees associated with clinical trial patients, in a timely and accurate basis. Ensures compliance of claims processing in accordance with insurance guidelines. Responsible for the day-to-day activities related to resolution of patient accounts up to and including: adding NCT ID#s, identifying information that was missing or posted in error, and releasing billing edits. Abstracts codes to facilitate an accurate database for research, planning, statistics and financial reimbursement.

Responsibilities:

• Performs daily review and reconciliation of billing edits for patients on non-industry sponsored trials.
• Verifies eligibility of clinical trail patients from database (clinical trials management system (CTMS) OnCore®).
• Enter NCT ID# in AMPFM for all non-industry sponsored trials and release for billing.
• Review and correct daily billing edit spreadsheet for bad NCT ID#s in AMPFM.
• Review and process all professional fees associated with clinical trial patients and supply NCT ID#s to vendors for insurance claims.

Qualifications:

• Bachelor's Degree required with minimum of 1-2 years previous workexperience in patient accounting; or equivalent combination of education andexperience.
• Demonstrated understanding of ICD-9-CM, CPT-4 (HCPCS) codingprotocols, and government regulations. Knowledge of edit reports in advance of electronic billing preferred.
• Knowledge of accounts invoices and accounts receivable preferred.
• Comprehensive knowledge of medical terminology, anatomy &physiology, pharmacology, disease processes, surgical and medical procedures.
• Computer application skills: Windows, Word, Excel, Outlook, Oncoreand CITRIX/CIS.

Equal Opportunity Employer of Minorities/Females/Disabled/Veterans