About the role
This position supports research financial processes across Loyola Medicine service lines. The role focuses on charge segregation, research billing compliance, Medicare Coverage Analyses (MCA), and dispute resolution to help ensure accurate and compliant billing for clinical research activities.
Key responsibilities include:
- Perform charge segregation and corrections in alignment with approved Medicare Coverage Analyses (MCA)
- Manage research financial workflows, including statement review and disputed charge resolution
- 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 with identifying and validating CPT codes for research-related procedures and services
- Collaborate with Revenue Integrity, Compliance, and other cross-functional teams to support compliant billing practices
- Provide backup support to the Clinical Research Business Analyst
- Follow federal, state, and local regulations, as well as Trinity Health policies and compliance standards
Requirements & Qualifications
Required qualifications:
- 2–4 years of experience in research, medical billing, or coding
- Strong knowledge of Medicare Coverage Analyses and the ability to interpret clinical trial documentation
- Experience with Epic systems, including reviewing and analyzing charge reports
- Solid understanding of clinical research billing regulations and workflows
- Strong analytical skills and attention to detail
- Ability to work independently, manage deadlines, and prioritize workload effectively
- Excellent communication skills and ability to work across multiple departments
Preferred qualifications:
- Bachelor’s degree in Finance, Healthcare Administration, or a related field, or equivalent experience
- Formal training in Medicare Coverage Analysis and/or clinical trial billing compliance
- CPC certification (AAPC)
- SOCRA or ACRP certification
Benefits & Perks
Benefits information is available through the employer's published Illinois transparency disclosure.
Location
Illinois, US
Employment Type
Full-time
Experience Level
Associate
Remote work allowed
No
Posted
1 month ago