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Senior Coding Coverage Analyst

Job Description:
Responsibilities The mission of the Financial Coverage & Activation Team (FCA) within the DGSOM's CTSI at UCLA is to streamline clinical research study activation while providing an institutional safeguard to ensure clinical research study budgets comply with applicable federal, state and local laws and regulations related to clinical research budgeting and billing.
FCA supports clinical research faculty and staff navigate the clinical research financial activation and amendment workflows within the UCLA Health System.
FCA Team members may perform clinical research study budget construction, validation, and analysis in both the UCLA Health System Clinical Research Management System (CRMS) and other software platforms (e.
g.
Excel).
FCA Team members endeavor to be campus experts in clinical research study activation, particularly in regards to budgeting and coverage, and are ambassadors in encouraging and supporting adoption and compliance with institutional best practices and policies, as well as Federal and State laws and guidelines.
Sr.
Coding Coverage Analyst will primarily perform the following key services and operational functions: Assess, identify, document and complete procedural coding for new and amended clinical research budgets and billing plans for all billable healthcare services required by assigned clinical research protocols; Undergo and maintain coverage analysis training and appropriately assess, identify, document and complete insurance coverage analysis for new and amended clinical research budgets and billing plans for all assigned clinical research protocols; Perform quality assurance for (1) and (2) above while also reconciling pre-study activation coding, pricing and coverage analysis billing designations with actual coding, pricing and billing designations applied to research claims.
Incumbent is expected to leverage reconciliation findings to appropriately modify existing and new study budgets, and continually improving study activation processes; Successfully export completed clinical research budgets and billing plans in a best practices format for research faculty and staff review and potential sponsor negotiations, as applicable; and Sr.
Coding Coverage Analyst is expected to develop and maintain strong working knowledge and familiarity with the UCLA Health System study activation process.
Incumbent is expected to demonstrate strong project management skills by completing assignments promptly, accurately and professionally.
Incumbent is expected to assist and support colleagues with team assignments and assistance with (1) through (4) above.
Sr.
Coding Coverage Analyst will assist and support colleagues and research-Connect team members in performance of their underlying mission to the Health System, including but not limited to: financial study activation, budget development and research pricing support, Medicare/Insurance Coverage Analysis, Local Coverage Determination processes, and liaison with other administrative research offices to streamline and triage research budgeting and pre-billing plans.
Incumbent is expected to build and maintain strong and positive working relationships with internal and external colleagues and stakeholders.
The position requires strong organizational, time management, multi-tasking and customer-focused oriented skills.
The incumbent should have and maintain current credentials in procedural coding, and be intimately familiar with clinical research financial workflows.
Qualifications Education:
Bachelors Degree, preferably in biological sciences or equivalent experience of at least 2 plus years in the clinical research AND/OR hospital finance/BILLING environment(s) Current Procedural Coding Certification (AAPC, AHIMA, etc.
).
ICD-9 familiarity, working experience, and/or relevant certification.
ICD-10 familiarity, working experience, and/or relevant certification.
Strong working knowledge of the full range of pre-award activities related to clinical trials research (e.
g.
, IRB, ISPRC, CIRC/ISRC, GCRC, other regulatory approvals, etc.
) Strong working knowledge of medical terminology.
Experience working collaboratively with faculty, administrators, and staff in an academic medical center, health care or university environment.
Familiarity and working knowledge of EPIC electronic medical records system as it relates to clinical research finance.
Proven ability to communicate positively and effectively in any and all work situations, and able to professionally participate in multidisciplinary discussions regarding the health sciences campus research process and related details to a wide audience (scientists, physicians, nurses, staff, sponsors, and the general public.
) Ability to follow instructions and work processes, and able to meet expected turnaround times on an ongoing basis and monitor, analyze, and improve processes on an ongoing basis, and work in a time-sensitive environment.
Ability to be flexible and adapt within an ever-changing, dynamic,

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