Perform independent, accurate, and timely review and analysis of research billing inquiries to resolve, provide guidance, or triage to appropriate staff for resolution.
Develop and implement education and communication outreach activities that will provide and document accurate and continuous research billing education programs for the OHSU community.
Collaborate with Epic Research Revenue Cycle and CTMS Support to provide input, evaluate, and test clinical research billing functionality in Epic and the CTMS.
Assist in reviewing new study creation, activation and post-activation processes for clinical research studies submitted to the CTMS.
Enter financial study information in the CTMS per study contract and/or finalized study budget.
Detailed review of new study creation and proposed changes, identify problematic areas and communicate directly with internal and external personnel.
The Clinical Research Services Office oversees industry-sponsored research contracting, clinical research billing compliance, OHSU's clinical trials management system, and federal reporting compliance. They also engage clinical research staff in community building, training, and education.
Partner with clinical trial staff and consortium study teams to communicate start-up process, milestones, and timeline goals.
Identify research costs and develop comprehensive budgets for single & multi-site industry sponsored clinical trials and IITs.
Monitor financial performance relative to budget and explain variances and trends.
Fred Hutchinson Cancer Center is a nonprofit organization focused on adult cancer treatment and research. They are based in Seattle and have a global leadership in bone marrow transplantation, HIV/AIDS prevention, immunotherapy and COVID-19 vaccines.
Submit bills compliant with all appropriate regulations and managed care contracts.
Collect money due by contacting third parties and providing explanations of charges.
Analyze accounts to determine coordination of benefits, refunds, and denials.
They are Oregon's only public academic health center, involved in patient care, research, and training healthcare professionals. As Portland's largest employer, they offer opportunities for learning and advancement in hospitals and clinics across Oregon and Southwest Washington.
Work directly with the client’s E-billing Manager on any ad-hoc e-bill related management/client requests.
Responsible for the submission of electronic invoices and accruals to clients, overseeing the transition of clients to e-billing.
Handle heavy volume of highly complex e-submission assignments for key corporate clients; ensure all client guidelines are followed during submission process.
RRD provides marketing, packaging, print, and business services to the world’s most respected brands. They use proprietary technology and advanced data analytics to fuel organizational decision-making from strategy through execution, delivering sustainable solutions.
Serve as a subject matter expert for front-end revenue cycle functions.
Investigate and resolve complex billing issues that prevent claims from being successfully accepted by payers.
Conduct root cause analysis on recurring front-end issues and implement process improvements to reduce claim errors and rework
Natera is a global leader in cell-free DNA (cfDNA) testing, dedicated to oncology, women’s health, and organ health. The Natera team consists of highly dedicated statisticians, geneticists, doctors, laboratory scientists, business professionals, software engineers and many other professionals from world-class institutions.
Responsible for daily billing functions and claim edits.
Reviews insurance claims for accuracy and identifies non-payment issues.
Contacts parties for claim information and works first-level appeals.
Kettering Health is a not-for-profit system of 14 medical centers and more than 120 outpatient facilities serving southwest Ohio. Their mission is to live God’s love by promoting and restoring health.
Manage day-to-day invoicing, payment tracking, payments adjustments, and review processes.
Serve as the primary contact for customer inquiries related to billing, payments, adjustments, penalties, and discrepancies.
Provide support to Billing and Collections Manager for daily invoicing, collection efforts, payments adjustments and audits.
Automatiq is the leading all-in-one software platform in the live event ticketing world, serving resellers of all sizes. We are data-driven and customer-obsessed as we work to solve interesting and complicated challenges in a fast-growing global market.
Analyze and improve UM business workflows, including clinical assessments, rules, and documents.
Validate Health Services programs against business requirements and acceptance criteria.
Partner with medical directors and cross‑functional teams to review, evolve, and update InterQual and custom clinical criteria.
Wellmark is a mutual insurance company owned by its policy holders across Iowa and South Dakota, and it has built its reputation on over 80 years of trust. They are motivated by the well-being of their members and committed to sustainability and innovation.
Perform in-depth reviews of medical claims utilizing the UB-04 and detailed itemized statements.
Verify the accuracy of itemized charges to be reimbursed according to client policy and industry standards.
Validate automatic system denials and create additions to enhance efficient processing of IBR claims.
Machinify is a healthcare intelligence company delivering value, transparency, and efficiency to health plan clients. They have a fully configurable and content-rich, AI-powered platform along with best-in-class expertise, deployed by over 85 health plans, including many of the top 20, representing more than 270 million lives.
Provides high quality customer service to both external and internal customers via verbal and written communication.
Maintains current working knowledge of managed care, insurance verification, and patient estimate practices and policies.
Coordinates with employment supervisor for pre-hire and onboarding processes to ensure all required training is completed.
OHSU is Oregon's only public academic health center which provides patient care, leads groundbreaking research, and trains health care professionals. As Portland's largest employer, they offer opportunities for learning and advancement across Oregon and Southwest Washington.
Responding to high volume inquiries via email/phone
Assist with triaging case volumes
Providing resolution guidance/support to care center staff on complex claims/billing inquiries; claim holds, overrides, take backs, corrected claim workflows, coding assistance
Privia Health is a technology-driven, national physician enablement company that collaborates with medical groups, health plans, and health systems to optimize physician practices, improve patient experiences, and reward doctors for delivering high-value care in both in-person and virtual settings. The Privia Platform consists of scalable operations and end-to-end, cloud-based technology that reduces unnecessary healthcare costs, achieves better outcomes, and improves the health of patients and the well-being of providers.