Strength Through Diversity
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Clinical Research Billing Analyst- Tisch Cancer Institute 2504682
The Clinical Research Billing Analyst will work in Cancer Clinical Trials Office (CCTO) under the supervision of the Financial Manager. The focus of this position is to ensure that research billing associated with cancer clinical trials is performed in a highly compliant fashion. This individual partners with the Ruttenberg Treatment Center (RTC) hospital staff to properly identify research patients and research services rendered in this hospital facility. The complexity of this task and the associated analysis calls for a dedicated individual who is highly trained for this role. The Research Binancial Analysts is also the key liaison between Pre-award and Post-award financial management. The importance of this role in terms of risk management and revenue maximization is high.
Roles & Responsibilities:
- “Translation” of the Medicare Coverage Analysis (MCA) into a Billing Summary Grid. This Grid is produced for every cancer protocol and specifies whether services rendered to research patients are “standard of care” ((SOC) and billable to patient insurance) or “research-related” (and billable to the sponsor of the clinical trial). This Grid is then shared with RTC coders, billers and MSH finance staff.
- Review lab and hospital invoices to verify whether all charges are correctly categorized as research vs. SOC and ensures that the visit time point and study number (GCO #) match the billing grid.
- Collect, analyze and distribute weekly detailed information of all scheduled research patient encounters. Included in this information are patient and protocol designation, clarification of the regimen “cycle”, labs and ancillary testing. RTC and finance staff uses this information to ensure that patient charges (by CPT code) are appropriately directed to either the patient’s insurance (SOC) or to the research sponsor (research-related).
- Maintain CCTO’s encounter metrics report.
- Identify and monitor of all cancer clinical trials in EPIC system. Must ensure that all current cancer protocols are appropriately updated and included in the clinical trials directory within EPIC.
- Complete the institutions Qualifying Clinical Trial analysis and Initial Status Review in the clinical trial management system, InfoEd.
- Facilitate the Confidentiality Disclosure Agreement process with sponsors and the Mount Sinai’s grants and contracts office. Responsible for keeping a log of the CDA’s and ensuring timely execution.
- Oversee budget amendments. The analyst reviews all protocol amendments to determine if budget changes are needed. He/she uses Mount Sinai’s charge master and works with administrators of other departments to determine costs and negotiate budget amendments with industry sponsors in order to ensure CCTO is being reimbursed appropriately.
- RAE reviews: assists financial research manager with Resource Allocation Evaluations and presents these evaluations to CCTO directors.
- Bachelor’s Degree.
- Prior experience in clinical research and/or patient billing is preferred.
- Highly organized individual comfortable with spreadsheets and data.
- Strong communication skills
- Critical to ensuring that the hospital and FPA are billing patient insurances in a compliant fashion. The risk of penalties associated with non-compliant billing must be avoided.
- Critical to ensure that the hospital is maximizing its revenue both from 3rd party insurances and also from the sponsors of clinical trials.
Strength Through Diversity
The Mount Sinai Health System believes that diversity and inclusion is a driver for excellence. We share a common devotion to delivering exceptional patient care. Yet we’re as diverse as the city we call home- culturally, ethically, in outlook and lifestyle. When you join us, you become a part of Mount Sinai’s unrivaled record of achievement, education and advancement as we revolutionize healthcare delivery together.
We work hard to recruit and retain the best people, and to create a welcoming, nurturing work environment where you have the opportunity and support to develop professionally. We share the belief that all employees, regardless of job title or expertise, have an impact on quality patient care.
Explore more about this opportunity and how you can help us write a new chapter in our story!
Over 38,000 employees strong, the mission of the Mount Sinai Health System is to provide compassionate patient care with seamless coordination and to advance medicine through unrivaled education, research, and outreach in the many diverse communities we serve.
Formed in September 2013, The Mount Sinai Health System combines the excellence of the Icahn School of Medicine at Mount Sinai with seven premier hospitals, including Mount Sinai Beth Israel, Mount Sinai Brooklyn, The Mount Sinai Hospital, Mount Sinai Queens, Mount Sinai West (formerly Mount Sinai Roosevelt), Mount Sinai St. Luke’s, and New York Eye and Ear Infirmary of Mount Sinai.
The Mount Sinai Health System is an equal opportunity employer. We promote recognition and respect for individual and cultural differences, and we work to make our employees feel valued and appreciated, whatever their race, gender, background, or sexual orientation.