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Posted: 04-Jun-25
Location: Durham, North Carolina
Internal Number: 257882
At Duke Health, we're driven by a commitment to compassionate care that changes the lives of patients, their loved ones, and the greater community. No matter where your talents lie, join us and discover how we can advance health together.
About Duke Health's Patient Revenue Management Organization
Pursue your passion for caring with the Patient Revenue Management Organization, which is Duke Health's fully integrated, centralized revenue cycle organization that supports the entire health system in streamlining the revenue cycle. This includes scheduling, registration, coding, billing, and other essential revenue functions.
Clinical Trials Billing Specialist
100% Remote Position
Schedule: Monday-Friday 8:00am-5:00pm
General Description of the Job Class
Reporting to the Manager of Clinical Trials Billing in the PRMO, the Clinical Trials Specialist plays a vital role in the success of DUHS' research billing program. By collaborating with clinical research personnel and consulting study documentation in the electronic medical record, the Clinical Trials Specialist facilitates accurate billing for patients enrolled in clinical trials in accordance with federal regulations to reduce both institutional and individual provider legal and financial risk.
Duties and Responsibilities of this Level
· Ensure that charges associated with grants and clinical trials are billed appropriately for both physician and hospital services. Diligently work reports and work queues to decrease bill hold accounts, and assist in communicating trends to reduce customer service issues/service now requests. Assist in educating principal investigators-study teams regarding compliance with government regulations, with special attention to CMS guidelines as pertaining to billing for patients enrolled in clinical trials. (40%)
· Consistently document and notate to aid education around identifying charges that are grant related or standard of care, and resolving discrepancies in timely manner. Provide education to clinical research staff on how to register patients for enrollment in trials and how to properly identify charges that are grant related versus standard of care. Assist in the analysis and audit of processes, and recommend changes and/or modifications to meet compliance and customer service goals. Facilitate communication between the clinical research coordinators and the CDM department to ensure compliance with DUHS and SOM rules regarding uniform discounted fees for clinical trials. (40%)
· Represent the PRMO inactively promoting initiatives with clinical faculty and administration. Perform other related duties incidental to the work described herein.(20%)
Education:
High school diploma or equivalent is required, preferably supplemented by post-secondary courses in Accounting, Finance, Economics, Business Administration or a related field.
Experience:
Four years of related experience in healthcare is required, with preference to Clinical Trials, Research Billing, and/or Specialty Billing experience.
Degrees, Licensure, and/or Certification:
Bachelor's degree in a related field can substitute for the experience requirement. Epic Research certification or other Epic certification not required but considered a plus.
Knowledge, Skills, and Abilities:
· Working knowledge of medical vocabulary and terminology principles with ability to apply to clinical trials billing operations
· Proficient in MS Office, Word, Excel and timely data entry into EMR
· Ability to interpret federal regulations and research/clinical trials billing compliance guidelines
· Actively participate in training sessions, and evaluate effectiveness through improvements in quality control and audit results
· System experience may include: Epic Resolute Hospital Billing, Epic Resolute Professional Billing, and Epic CRM
· Effective verbal and written communication skills; leading to efficient and accurate resolution of clinical trials issues
· Data collection, reporting, and charge analysis
Duke is an Equal Opportunity Employer committed to providing employment opportunity without regard to an individual's age, color, disability, gender, gender expression, gender identity, genetic information, national origin, race, religion, sex (including pregnancy and pregnancy related conditions), sexual orientation or military status.
Duke aspires to create a community built on collaboration, innovation, creativity, and belonging. Our collective success depends onthe robust exchange of ideas-an exchange that is best when the rich diversity of our perspectives, backgrounds, and experiences flourishes. To achieve this exchange, it is essential that all members of the community feel secure and welcome, that the contributions of all individuals are respected, and that all voices are heard. All members of our community have a responsibility to uphold these values.
Essential Physical Job Functions: Certain jobs at Duke University and Duke University Health System may include essential job functions that require specific physical and/or mental abilities. Additional information and provision for requests for reasonable accommodation will be provided by each hiring department.