Company Name:
UCLA HEALTH
Approximate Salary:
Not Specified
Location:
Westwood, California
Country:
United States
Industry:
Healthcare

CRB Compliance Auditor & Trainer

Job Duties

Under the direct supervision of the Manager of Clinical Research Billing Compliance, this position is primarily responsible for the monitoring and auditing of clinical research billing activities at UCLA Health System to help ensure compliance with applicable statutes, laws, rules, regulations and policies.

Additional responsibilities include, but are not limited to:

Assist on preparing regular and ad hoc reports and/or dashboards on compliance activities in support of clinical research billing functions
Assist on compiling, updating and revising policies and procedures to help ensure optimal management of and oversight of clinical research billing functions
Assist in monitoring the effectiveness of compliance activities related to clinical research billing
Assist in monitoring compliance with applicable statutes, laws, rules, regulations and policies affecting PHI of study participants
Assist on preparing and conducting educational and training programs related to clinical research billing compliance
Collaborate and communicate with other entities or units within UCLA Health System on matters related to clinical research billing compliance
Research, analyze and assist on regulatory advice to entities, units or individuals engaged in clinical research billing at UCLA Health System
Conduct routine and focused auditing and monitoring efforts to help ensure compliant research billing functions
As appropriate, assist in the development, implementation, review and revision of policies and procedures for clinical research billing compliance
As appropriate, assist in the conduct of periodic risk assessment to identify risk areas in clinical research billing compliance, conflicts of interest, allocation of charges and effort reporting
As appropriate, review and analyze patient obligation language in informed consents in conjunction with the study contract and Medicare Coverage Analysis grid, to help identify and prevent billing errors
Assist in the investigation of reports, concerns, issues and allegations of non-compliant practices in clinical research billing
As appropriate, assist in the development of corrective action and remediation plans when necessary
Assist in coordinating the preparation of reports to regulatory agencies, when appropriate
Facilitate responses to requests for information and investigations initiated by regulatory oversight or law enforcement agencies, when appropriate
Stay current with applicable statutes, laws, rules, regulations and policies related to clinical research billing and develop mechanisms to disseminate relevant regulatory information or developments to entities, units or individuals engaged in clinical research billing at UCLA Health System
Assist on preparing and conducting educational programs related to clinical research billing compliance


Job Qualifications

Bachelor's degree from an accredited institution in a related field or equivalent credentials
Proficiency in clinical research billing
Proficiency in healthcare coding (CPT, ICD-9/ICD-10, DRG, HCPCS)
Three years of experience in an academic medical center environment or equivalent setting with emphasis on clinical research operations
Excellent oral and written communication skill
Excellent organizational and analytical skill
Excellent attention to detail
Certification as CCRP or CHRC preferred
Knowledge and understanding of federal and state statutes, laws, rules and regulations affecting the provision and reimbursement of healthcare services, particularly clinical research billing, grant funding and management
Knowledge and understanding of the Medicare Clinical Trial Policy (CTP) and Medicare Coverage Analysis
Knowledge and understanding of hospital and professional billing, coding and documentation practices in inpatient and outpatient settings
Detailed knowledge of clinical research billing, coding and documentation practices in inpatient and outpatient settings
Working knowledge of clinical research processes
Working knowledge of electronic billing and medical record system
Working knowledge of anatomy and physiology
Working knowledge of sampling methodologies and statistical analyses
Ability to effectively communicate in a public forum or group setting
Ability to conduct effective and accurate regulatory research and analysis
Ability to develop and implement automated processes to organize complex data
Ability to establish and maintain excellent professional and effective relationships with internal and external entities
Ability to deal effectively with ambiguity
Ability to appropriately prioritize work responsibilities and effectively manage fluctuating workload demands
Ability to perform analytical tasks and accurate calculations

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