Financial Analyst ResearchRevenue Cycle

Job Description

The Financial Analyst- ( research and revenue cycle focused) reflects the mission, vision, and values of NM, adheres to the organization’s Code of Ethics and Corporate Compliance Program, and complies with all relevant policies, procedures, guidelines and all other regulatory and accreditation standards.

Responsibilities

1. Review designated Epic work queues routinely and facilitate allocation of charges in alignment with the coverage analysis to ensure timely and compliant billing.
2. Review and reference study documents (protocol, consent form, budget, clinical trial agreement, coverage analysis) to identify research related charges impacting NMHC, and to ensure and support compliant billing.
3. Maintain a detailed understanding of and adhere to rules and regulations of different types of payors, such as Medicare, Medicare Advantage, Medicaid, and commercial payors, inclusive of Medicare’s Clinical Trial Policy (NCD 310.1) and related guidance.
4. Act as a resource to research teams to aid in identification of items and services related to the research and assignment of the appropriate payor.
5. Maintain knowledge and proficiency in Epic, clinical trial management system, charge master/fee schedule, and relevant government and non-government websites.

Qualifications:

Required:

• 3+ years of relevant experience.
• Ability to understand and interpret medical documentation and clinical research protocols, informed consent, Coverage Analysis Billing Grid.
• Proficiency with medical terminology as well as medical research billing language.
• Excellent communication, collaboration, analytical, and accounting skills.
• High level of precision and attention to detail.
• Expert knowledge of Microsoft Office Suite.

Preferred:

• Degree Specific Associates Degree.
• Working knowledge of Epic, Knowledge of medical and insurance terminology.
• Understanding of Medicare billing rules and functional knowledge of essential National Coverage Decisions and the CMS Clinical Research Policy.
• Healthcare finance experience.

Additional Information

Northwestern Medicine is an affirmative action/equal opportunity employer and does not discriminate in hiring or employment on the basis of age, sex, race, color, religion, national origin, gender identity, veteran status, disability, sexual orientation or any other protected status.