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Job Information

McLaren Health Care Billing Spec I Clinical Trials in Detroit, Michigan

Description

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

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

Job: Administrative/Clerical

Primary Location: Michigan-Detroit-Mid Med Building

Employee Status Regular

Shift Day Job

Job Type Standard

Schedule Full-time

Req ID: 20001932

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