Clinical Trial Financial Analyst

Job : R-47899 Job Type: Full time Location: Lenexa, Kansas

Responsible for the coordination and creation of coverage analyses for all clinical trials in accordance with the Center for Medicare and Medicaid Services (CMS) regulations and institutional policies, and responsible for the creation of a clinical trial billing matrix to determine appropriate payors and responsible parties for charges.

• Creates coverage analysis grids and analyzes performance using CMS regulations, FDA guidance, Good Clinical Practice guidelines, and ethical policies.
• Researches and applies policies, guidance, and guidelines from federal and state regulatory agencies and The University of Kansas Hospital policies.
• Disseminates relevant documents and information to various parties.
• Performs basic and complex billing and budget analysis in accordance with CMS regulations for all clinical trials performed at The University of Kansas Hospital and affiliates.
• Serves as liaison to the budget & financial analysts at the KUMC Research Institute and KU Cancer Center Clinical Trials Office, collaborating closely to ensure consistency and appropriateness of the clinical trial budget, coverage analysis, and billing matrix.
• Develops billing matrices and coverage analyses, reviewing each potentially billable item within the clinical trial and citing specific resources for justification of designations.
• Applies the appropriate CDM and CPT codes for potentially billable items in the coverage analysis to assist Patient Financial Services in claim review and to identify items billed to the study sponsor by the KUMC Research Institute.
• Assists with claims review to distinguish research charges billed to the study from those that may be billed to insurance payors.
• Performs required professional, clinical, and/or technical competencies of the assigned unit or department.
• These statements describe essential functions and are not exhaustive. Additional responsibilities may be assigned as required.

• High School Graduate
• 3+ years of experience in Clinical Research Billing and/or Billing Compliance.
• 2+ years of experience in Budgeting and Medicare Coverage Analysis Development.

• Bachelor’s Degree in a related field from an accredited college or university.
• Experience with Epic.
• Experience with electronic Clinical Trial Management Systems.

• Certified Professional Coder (CPC) – American Academy of Professional Coders (AAPC).

• English

• Demonstrated understanding of Research Billing Compliance, including National Coverage Determination for routine costs and the CMS Clinical Research Policy.
• Knowledge of regulatory, financial, and administrative requirements of Medicare and third-party billing of clinical trials – proficient in Excel, Word, PowerPoint.
• Proficiency in Medical Terminology.

We are an equal employment opportunity employer without regard to a person’s race, color, religion, sex (including pregnancy, gender identity and sexual orientation), national origin, ancestry, age (40 or older), disability, veteran status, or genetic information.