Overview Oversee day-to-day billing operations for research/clinical trials, transplant services, and client/corporate billing portfolios across HB and PB. Ensure accurate, compliant, and timely claim production and sponsor/client invoicing; minimize billing-driven denials and avoidable write-offs; accelerate cash and improve billing quality through standardized workflows, controls, and cross-functional collaboration.

Qualifications Education:

Associate degree in Healthcare Administration, Healthcare Management, or a related field highly preferred.

Experience:

Minimum of 3 to 4 years of progressive revenue cycle experience , including at least 1 to 2 years in billing operations (HB and/or PB) within a hospital or multi-site health system with a two-year degree.

• Minimum of 3 years of supervisory experience in hospital and/or professional billing operations.
• A formal degree may be substituted with 6+ years of direct, hands-on revenue cycle and supervisory experience .
• Demonstrated experience with Epic and revenue cycle technologies.
• Proven success leading teams through organizational change and process improvement initiatives.

License/Certification/Registration:

Not required.

• Deep expertise in: Hospital Billing (HB) and Professional Billing (PB) Research billing operations Transplant billing processes Client and corporate billing environments
• Working knowledge of: HIPAA compliance and privacy requirements Research billing audit practices Clinical trial billing regulations Transplant billing regulatory requirements
• Thorough understanding of: CMS and commercial payer billing regulations UB-04 and

CMS-1500

claim forms NCCI edits Medically Unlikely Edits (MUEs) Local Coverage Determinations (LCDs) National Coverage Determinations (NCDs) Timely filing requirements and specialty case implications

• Research billing expertise, including: Sponsor billing Study budget management Billing grids Clinical trial compliance Investigational charge capture Sponsor invoicing and reconciliation
• Transplant billing expertise, including: Organ acquisition cost accounting DRG and bundling methodologies Transplant modifiers Coordination with Organ Procurement Organizations (OPOs)
• Client and corporate billing proficiency, including: Contract invoicing Third-party billing Departmental billing Special program billing Statement generation and reconciliation processes
• Strong ability to interpret and reconcile: Sponsor agreements Payer coverage determinations Institutional billing policies Billing responsibilities to prevent duplicate billing and ensure compliance
• Demonstrated change leadership and continuous improvement mindset, including experience implementing: Standardized playbooks Workflow optimization initiatives Automation solutions
• Excellent written and verbal communication skills.
• Strong cross-functional collaboration skills with the ability to work effectively across operational, clinical, research, financial, and compliance teams.
• Technical proficiency with: Epic and revenue cycle management (RCM) systems Research billing modules Work queue configuration Reporting and analytics tools Electronic sponsor invoicing platforms.

Qualifications:

Education:

Associate degree in Healthcare Administration, Healthcare Management, or a related field highly preferred.

Experience:

Minimum of 3 to 4 years of progressive revenue cycle experience , including at least 1 to 2 years in billing operations (HB and/or PB) within a hospital or multi-site health system with a two-year degree. Minimum of 3 years of supervisory experience in hospital and/or professional billing operations. A formal degree may be substituted with 6+ years of direct, hands-on revenue cycle and supervisory experience . Demonstrated experience with Epic and revenue cycle technologies. Proven success leading teams through organizational change and process improvement initiatives.

License/Certification/Registration:

Not required.

Deep expertise in:

Hospital Billing (HB) and Professional Billing (PB) Research billing operations Transplant billing processes Client and corporate billing environments Working knowledge of: HIPAA compliance and privacy requirements Research billing audit practices Clinical trial billing regulations Transplant billing regulatory requirements Thorough understanding of: CMS and commercial payer billing regulations UB-04 and

CMS-1500

claim forms NCCI edits Medically Unlikely Edits (MUEs) Local Coverage Determinations (LCDs) National Coverage Determinations (NCDs) Timely filing requirements and specialty case implications Research billing expertise, including: Sponsor billing Study budget management Billing grids Clinical trial compliance Investigational charge capture Sponsor invoicing and reconciliation Transplant billing expertise, including: Organ acquisition cost accounting DRG and bundling methodologies Transplant modifiers Coordination with Organ Procurement Organizations (OPOs) Client and corporate billing proficiency, including: Contract invoicing Third-party billing Departmental billing Special program billing Statement generation and reconciliation processes Strong ability to interpret and reconcile: Sponsor agreements Payer coverage determinations Institutional billing policies Billing responsibilities to prevent duplicate billing and ensure compliance Demonstrated change leadership and continuous improvement mindset, including experience implementing: Standardized playbooks Workflow optimization initiatives Automation solutions Excellent written and verbal communication skills. Strong cross-functional collaboration skills with the ability to work effectively across operational, clinical, research, financial, and compliance teams.

Technical proficiency with:

Epic and revenue cycle management (RCM) systems Research billing modules Work queue configuration Reporting and analytics tools Electronic sponsor invoicing platforms.