Position Summary/Essential Duties:

· Ensure compliant research billing practice for assigned department(s) at University Hospitals Cleveland Medical Center and UHHS, including comprehensive knowledge & application of CMS regulations, maintaining UH billing standards, and record maintenance including accurate grant reporting. (45%)

· Demonstrate efficient task performance, high level of organization and the maintenance of accurate administrative records, including database entries and reporting, to meet management goals. (15%)

· Through effective communication, provides guidance to colleagues and assists department research personnel in research patient billing matters. (10%)

Track One: CA Focus

· Develop patient care clinical project budgets which meet compliance and fiscal standards, utilizing thorough knowledge of coverage analysis and budgeting principles. Assist in negotiation of budget with Sponsor. (30%)

or

Track Two: Claim Management Focus

· Partner with revenue cycle to assist with resolving research claim denials, manage third party insurance issues, and independently process complex research claims according to CMS or private payor rules to ensure maximum payment recovery on outstanding billing. (30%)