About the role
Employment Type
Full time
Shift
Day Shift
Description
About the Role
This role will support research financial processes across Loyola Medicine service lines. This role is critical to ensuring accurate charge segregation, maintaining research billing compliance, managing Medicare Coverage Analyses (MCA), and resolving billing disputes.
What You’ll Do
- Perform charge segregation and corrections in alignment with approved Medicare Coverage Analyses (MCA)
- Manage research financial workflows, including statement review and resolution of disputed charges
- Identify and escalate high-risk studies and potential audit concerns
- Independently review, update, and amend Medicare Coverage Analyses based on clinical trial documentation
- Maintain and update research fee schedules
- Assist in identifying and validating CPT codes for research-related procedures and services
- Collaborate with cross-functional teams (e.g., Revenue Integrity, Compliance) to ensure compliant billing practices
- Provide back-up support to the Clinical Research Business Analyst
- Ensure adherence to federal, state, and local regulations, as well as Trinity Health policies, Code of Conduct, and compliance standards
- Demonstrate Trinity Health Mission, Values, Vision, and guiding behaviors in daily work
What You’ll Need
Required Qualifications
- 2–4 years of experience in research, medical billing, or coding
- Strong knowledge of Medicare Coverage Analyses, with the ability to interpret and apply clinical trial documentation
- Experience working with Epic systems, including reviewing and analyzing charge reports
- Solid understanding of clinical research billing regulations and workflows
- Strong analytical skills with high attention to detail
- Ability to work independently, manage competing deadlines, and prioritize workload effectively
- Excellent communication skills with the ability to work across multiple departments
Preferred Qualifications
- Bachelor’s degree in Finance, Healthcare Administration, or a related field (experience may substitute for education)
- Formal training in Medicare Coverage Analysis and/or clinical trial billing compliance
- Certified Professional Coder (CPC – AAPC) preferred
- SOCRA or ACRP certification preferred
Compensation
Salary Range: $31.06 - $48.15 per hour
Actual compensation will fall within the range but may vary based on factors such as experience, qualifications, education, location, licensure, certification requirements, and comparisons to colleagues in similar roles.
Benefits
Our Commitment
Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law.
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