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The Clinical Trials and Transplant Billing Manager plays a critical role in ensuring accurate and compliant billing for clinical trials and transplant billing. This position collaborates with Clinical Trial Principal Investigators (PIs), Business Managers, and Clinical Research Coordinators to interpret protocol activity schedules for research trial budget billing. The manager works closely with the Clinical Research Finance to prepare, review, and monitor protocol budget schematics and ensure compliance with billing protocol and agreements. This position also works with Cell Therapy Business Administration and partner institutions to coordinate charge management and routing for transplant-related charges.

This role involves developing and managing functions related to patient billing activities for research and transplant subjects. The manager maintains up-to-date knowledge of standard billing practices and compliance standards within the research community and assists in reconciling collected research funds to ensure billing compliance with third-party payers. The position also involves ensuring patient confidentiality as outlined by HIPAA and conducting routine audits of the research charges. Additional duties may be assigned as needed.

Located in Boston and the surrounding communities, Dana-Farber Cancer Institute is a leader in life changing breakthroughs in cancer research and patient care. We are united in our mission of conquering cancer, HIV/AIDS and related diseases. We strive to create an inclusive, diverse, and equitable environment where we provide compassionate and comprehensive care to patients of all backgrounds, and design programs to promote public health particularly among high-risk and underserved populations. We conduct groundbreaking research that advances treatment, we educate tomorrow's physician/researchers, and we work with amazing partners, including other Harvard Medical School-affiliated hospitals.

Clinical Trials Billing (80%):

• Manage and oversee billing processes for clinical trials to ensure accuracy and compliance

• Collaborate with Clinical Trials Finance Office(rs), Clinical Research Coordinators, PIs, and Business Managers to ensure accurate interpretation and implementation of protocol activity schedules for billing purposes

• Work with the Office of Sponsored Research to develop and monitor protocol budget schematics and ensure billing compliance

• Develop and manage Clinical Trials Database functions related to study schematics and patient billing activities

• Manage the Clinical Trials Billing Specialists (CTBS) for Patient Accounting

• Hire, train, and evaluate clinical trials billing staff on protocols, billing grids, and billing processes

• Assign and oversee work of the CTBS to ensure Patient Accounting department is identifying the appropriate research charges

• Maintain current knowledge of clinical trials billing regulations and compliance standards

• Assist in reconciling research funds to ensure billing compliance with third-party payers

• Conduct routine audits of billing processes and databases to ensure accuracy and compliance

• Ensure patient confidentiality in accordance with HIPAA regulations

Transplant Billing (10%):

• Manage and oversee inter-institutional billing processes for transplant claims

• Collaborate with Dana-Farber Cell Therapy Business Administration and partner institutions to ensure accurate charge capture and routing

• Manage the Transplant Billing Specialist in Patient Accounting

• Hire, train, and evaluate staff on charge capture process, revenue reviews and billing processes

• Maintain current knowledge of transplant billing regulations and compliance standards

• Assist in reconciling work queues to ensure billing accuracy and compliance partner institutions

• Conduct routine audits of billing processes

Process Improvement (10%):

• Identify opportunities for process improvement within the revenue cycle, focusing on enhancing efficiency, accuracy, and compliance.

• Perform project management activities and works with other managers to ensure Epic related issues are being appropriately

• Use metrics as much as possible to identify and analyze data integrity and timeliness issues

• Develop and implement process improvement initiatives, leveraging data analysis and best practices

• Monitor the effectiveness of implemented changes and adjust as necessary to achieve desired outcomes

• Perform root cause analysis and identify solutions for clinical trial billing-related issues

SUPERVISORY RESPONSIBILITIES:

• Direct supervisory responsibility of a team of billing specialists

• Bachelor’s degree required; MBA or Finance Degree preferred

• 5 years of related experience in hospital billing; clinical research billing experience preferred.

• People management experience required.

KNOWLEDGE, SKILLS, AND ABILITIES REQUIRED:

• Direct knowledge of third-party payer rules and regulations, clinical trials, and insurance billing operations as well as hospital financial systems

• Project, financial, and people management skills; capable of bringing all three together when conflicting priorities exist

• Knowledge of healthcare billing codes including CPT, HCPC, and familiarity with ICD-10 diagnosis codes

• Strong written and verbal communication skills

• Demonstrated ability to coach staff through change and mentor newer staff along their learning journey

• Demonstrated self-awareness, strong professionalism, a strong work ethic, and the ability to handle difficult situations effectively and efficiently

• Strong interpersonal skills (i.e., ability to work closely and effectively with all levels of the organization)

• Ability to conduct duties in a polite, forthright manner, articulately communicating with others and utilizing discretion, judgment, common sense, and timeliness in customer service and decision making

• In-depth knowledge of clinical trials billing regulations and patient accounting procedures

• Ability to manage large volumes of data and meet deadlines

At Dana-Farber Cancer Institute, we work every day to create an innovative, caring, and inclusive environment where every patient, family, and staff member feels they belong. As relentless as we are in our mission to reduce the burden of cancer for all, we are equally committed to diversifying our faculty and staff. Cancer knows no boundaries and when it comes to hiring the most dedicated and diverse professionals, neither do we. If working in this kind of organization inspires you, we encourage you to apply.

Dana-Farber Cancer Institute is an equal opportunity employer and affirms the right of every qualified applicant to receive consideration for employment without regard to race, color, religion, sex, gender identity or expression, national origin, sexual orientation, genetic information, disability, age, ancestry, military service, protected veteran status, or other characteristics protected by law.

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