Michigan Medicine is seeking an Intermediate Research Billing Compliance Specialist to support the accurate review, adjudication, and processing of clinical research charges. This role helps ensure research billing activities align with Coverage Analysis determinations, study billing grids, institutional policies, and applicable federal research billing regulations.
The position works closely with research teams, billing partners, and compliance staff to support accurate charge routing, proper documentation, timely issue resolution, and compliant billing practices across research studies.
Key responsibilities include reviewing hospital and professional charges for clinical trials, resolving denials and charge edits, maintaining compliance with Medicare and other payer guidelines, and supporting research billing inquiries from internal stakeholders.
Required Qualifications
- Bachelor’s degree in Business, Finance, Health Information Management, or a related field; or equivalent experience/certifications.
- Minimum of 3 years of experience in a healthcare revenue cycle or clinical operations role, with experience in healthcare compliance, general healthcare billing, research billing, or research billing compliance.
- Knowledge of CMS billing rules and regulations, including National Coverage Determinations, Local Coverage Determinations, and the Clinical Trial Policy (NCD 310.1).
- Familiarity with CPT/HCPCS coding and hospital billing (UB-04/1500).
- Experience with electronic health record systems.
Desired Qualifications
- Bachelor’s degree in Business, Finance, or a healthcare field with at least 5 years of experience in professional and hospital billing, facility coding, and/or reimbursement.
- ACRP/SoCRA or equivalent certification preferred.
- Familiarity with government and non-government websites and information systems used in detailed review.
- Knowledge of University of Michigan and UMHS policies, procedures, and regulatory requirements.
- Proficiency with MiChart, IRB processes, E-Research, Clinical Trial Protocols, OnCore, and compliance workflows.
- Strong analytical, organizational, and problem-solving skills.
- Ability to meet goals in a fast-paced, high-volume environment.
- Excellent medical, dental, and vision coverage effective on the first day
- 2:1 match on retirement savings
Location
Michigan, US
Employment Type
Full-time
Experience Level
Intermediate Level
Remote work allowed
Yes
Posted
4 weeks ago