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