The Clinical Trials Billing Specialist is an important part of the Research Team at OOS and responsible for reviewing charges, coding, system build of clinical trials, billing compliance and auditing related to clinical trial charges.
Essential Job Functions
Build clinical trial protocols in practice management system based on coverage analysis
Compare charges against coverage analysis breakdown to determine clinical trial versus standard of care billing and bill charges accordingly
Review charges and codes prior to submitting claims to either insurance or sponsor for compliance
Complete prior authorization of services according to insurance guidelines prior to clinical trial services
Perform reviews of insurance guidelines and requirements for clinical trials including billing, coding, prior authorizations ensuring compliance
Follow up on claims for correct payments and timeliness
Provide financial counseling to clinical trial patients regarding their expected out of pocket and billing guidelines prior to enrolling in study.
Other duties as assigned
Post-secondary education or certification in medical coding, business or health-related field
2 years of coding or medical billing experience
Working knowledge of CMS clinical trial policy
Working knowledge of medical terminology, medical billing, and billing compliance
Strong analytical, communication and problem-solving skills; proficient with spreadsheets/databases
Demonstrated attention to detail and the ability to methodically review accounts to assure proper billing
About Oregon Oncology Specialists
At Oregon Oncology Specialists, we are dedicated to providing the highest quality care. Our physicians are highly trained experts who treat every patient with precision, confidence and compassion.
We specialize in the latest treatments and most advanced therapies, delivering outcomes that meet or exceed even the largest cancer centers. As a growing research program, we are committed to providing potentially promising therapies and novel opportunities to our patients here in our community.
As a growing research team, we are looking for an experienced Clinical Trial Billing Specialist to join us.