Clinical Trials Billing Specialist

About the role

The Clinical Trials Billing Specialist supports the Clinical Trials Billing Manager by ensuring accurate and timely billing for industry‑sponsored research studies. The role involves reviewing medical records, applying coding standards, and coordinating with multiple stakeholders to maintain compliance.

Key responsibilities

• Review medical records and research documentation to verify correct coding (CPT, ICD‑10, HCPCS) and capture all billable services.
• Apply CMS regulations and third‑party payer guidelines to ensure proper claim submission.
• Respond to billing inquiries, process corrections, and manage monthly professional and facility charge invoices.
• Link patient encounters to the appropriate research study in the EHR system and handle study close‑out procedures.
• Assist with financial audits, study reconciliation, and data integrity in the Clinical Trials Management System.
• Distribute invoices to relevant departments and follow up on unpaid balances.

Required profile

• Associate’s degree plus two years of related experience, or High School Diploma plus four years of medical/research billing experience.
• Knowledge of Medicare/medical billing and coding processes.
• Familiarity with CMS regulations and third‑party payer rules.
• Ability to maintain confidentiality and manage multiple tasks efficiently.

Required skills

• Medical and research billing/coding using CPT, ICD‑10, HCPCS.
• Working knowledge of EPIC electronic health record system.
• Intermediate Excel skills.
• Proficiency with electronic health record and practice management software.