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Research Compliance Spec Sr

Job Summary

Revenue Cycle Research Billing Compliance Sr. representative for comprehensive review, analysis, resolution, and compliance of clinical Trial billing, and implementation/integration of new processes and technology for the Revenue Cycle Compliance Division. Reporting to the Manager of Revenue Cycle Research and Provider Enrollment Compliance, this position will ensure Revenue Cycle billing and system update/integration compliance at a comprehensive level. This position requires an in-depth understanding of Revenue Cycle processes and workflows, clinical trial billing and protocols, and MiChart interfaces. This role will identify and resolve non-standard Revenue Cycle inquiries as well as create standard workflows for outliers. This role requires thorough and current knowledge of the clinical trial start-up process, and the steps taken from study approval to open to enrollment. Responsible for development and implementation of LEAN workflows to support efficient billing and collections strategies to maximize income within Compliance Division purview. Requires fast-paced, highly productive skills to meet division goals. Provides continuous comprehensive, detailed analyses of findings that encompass claim submission and status, payment history, rejection analysis, frequency, and status of unpaid claims via strict communication and on-going updates to department administration, providers, and coders. Works closely with Michigan Medicine peers and partners to enhance workflows, create good business relationships and maintain a high level of support. Assists with the development of EPIC training and educational programs for the Compliance Division while demonstrating project management skills to independently carry out projects as assigned or appropriate. Impeccable attention to detail with high level of accuracy. Research policies of payers and communicates changes as appropriate. Maintains regular interactions and communication with Third Party Payers while ensuring compliance with Michigan Medicine, governmental and all third-party regulations, including claim submission, coding accuracy and documentation to support billing. Performs quality assurance and assesses degree of risk for non-compliance with internal audit findings. Creates and reports department metrics. This role is assigned special projects, data integrity audits, and system testing.

Responsible for study participant research charge review, import from Oncore to MiChart, creation of research accounts, setting up general ledger and short code in MiChart, grant IDMT and R2W access for our Michigan Medicine partners, review and adjudication of PB and HB items and services, monitor and analyze Compliance Division processes and workflows. May be asked to assist with other assigned duties within Revenue Cycle Compliance Division.

Mission Statement

Michigan Medicine improves the health of patients, populations and communities through excellence in education, patient care, community service, research and technology development, and through leadership activities in Michigan, nationally and internationally. Our mission is guided by our Strategic Principles and has three critical components; patient care, education and research that together enhance our contribution to society.

Why Join Michigan Medicine?

Michigan Medicine is one of the largest health care complexes in the world and has been the site of many groundbreaking medical and technological advancements since the opening of the U-M Medical School in 1850. Michigan Medicine is comprised of over 30,000 employees and our vision is to attract, inspire, and develop outstanding people in medicine, sciences, and healthcare to become one of the world’s most distinguished academic health systems. In some way, great or small, every person here helps to advance this world-class institution. Work at Michigan Medicine and become a victor for the greater good.

What Benefits can you Look Forward to?

+ Excellent medical, dental and vision coverage effective on your very first day

+ 2:1 Match on retirement savings

Responsibilities*

+ Perform comprehensive review and analysis and provide feedback/improvement recommendations on Compliance Division accounts receivable.

+ Performs quality assurance and assesses degree of risk.

+ Creates, documents, and implements technology and workflow enhancements.

+ Perform comprehensive reconciliation review.

+ Engages in new employee training.

+ Engages in system testing.

+ Performs data integrity audits.

+ Prepares and reports metrics.

+ Performs comprehensive review of PB and HB Compliance Division charges.

+ Process/resolve customer inquiries.

+ Process charge review and charge correction.

+ Perform complexandtimelyreviewof allPBandHBclinicaltrialitemsandservicesfor proper adjudication according to federal guidelines.

Required Qualifications*

+ Bachelor's Degree in Health or Business Administration or 5+ years of experience working directly in Revenue Cycle Billing or equivalent combination of education and experience.

+ 3+ years of experience conducting compliance audits

+ Demonstrated knowledge of LEAN principles.

+ Demonstrated ability to meet or exceed institutional goals and priorities in a fast-paced, high-volume environment.

+ Comprehensive knowledge of Revenue Cycle processes and workflows.

+ Comprehensive problem solving.

+ Knowledge of 3rd party reimbursement policies and procedures.

+ Proficiency in use of computers and software, including MiChart, OnCore, Microsoft Office, Excel, Outlook.

+ Demonstrated excellent verbal and written communication skills.

+ Demonstrated ability to multi-task high priority items.

+ Demonstrated ability to work independently.

+ Demonstrated ability to work in a team environment and build trusting, supportive relationships.

+ Demonstrated attention to details.

Desired Qualifications*

Bachelor's Degree in Health or Business Administration or 7+ years of experience working directly in Revenue Cycle Billing or equivalent combination of education and experience. Proficiency in the EPIC billing system and knowledge of clinical trial management system(s). Thorough knowledge of Medicare Clinical Trials and Enrollment Policies, National Coverage Decisions, Local Coverage Decisions, and Limitations on Coverage, medical claims coding practices and clinical processes. Strong working knowledge and experience with clinical trial regulatory documents such as protocols and informed consents and Clinical Trial Agreements (CTA).

Modes of Work

Positions that are eligible for hybrid or mobile/remote work mode are at the discretion of the hiring department. Work agreements are reviewed annually at a minimum and are subject to change at any time, and for any reason, throughout the course of employment. Learn more about thework modes (https://hr.umich.edu/working-u-m/my-employment/ways-we-work-resource-center/ways-we-work-implementation-group/modes-work) .

Background Screening

Michigan Medicine conducts background screening and pre-employment drug testing on job candidates upon acceptance of a contingent job offer and may use a third party administrator to conduct background screenings. Background screenings are performed in compliance with the Fair Credit Report Act. Pre-employment drug testing applies to all selected candidates, including new or additional faculty and staff appointments, as well as transfers from other U-M campuses.

Application Deadline

Job openings are posted for a minimum of seven calendar days. The review and selection process may begin as early as the eighth day after posting. This opening may be removed from posting boards and filled anytime after the minimum posting period has ended.

U-M EEO Statement

The University of Michigan is an equal employment opportunity employer.

Job Detail

Job Opening ID

266405

Working Title

Research Compliance Spec Sr

Job Title

Research Compliance Spec Sr

Work Location

Michigan Medicine - Ann Arbor

Ann Arbor, MI

Modes of Work

Mobile/Remote

Full/Part Time

Full-Time

Regular/Temporary

Regular

FLSA Status

Exempt

Organizational Group

Exec Vp Med Affairs

Department

MM Rev Cycle (PTO)

Posting Begin/End Date

7/21/2025 - 7/28/2025

Career Interest

Research