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Job Details

CRB Compliance Auditor amp Trainer

Company name
UCLA Health System

Los Angeles, CA

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Job Description:

Job Description:

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

Complete Application

Company info

UCLA Health System
Website :

Company Profile
For more than half a century, UCLA Health System has provided the best in healthcare and the latest in medical technology to the people of Los Angeles and throughout the world.UCLA Medical Center is at the cutting edge of biomedical research, and our doctors and scientists are leaders in performing pioneering work across an astounding range of disciplines, from organ transplantation and cardiac surgery to neurosurgery and cancer treatment, and bringing the latest discoveries to virtually every field of medicine.

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