Clinical Trials Medicare Coverage Analyst

This is a fully remote position, open to applicants in United States.

📋 Description

• Perform Medicare Coverage Analyses for both oncology and non-oncology clinical trial protocols.

• Determine which procedures and services can be billed to Medicare as opposed to those related to research.

• Examine protocols, schedules of events, and informed consent forms to ensure compliance with CMS billing standards.

• Create, maintain, and validate OnCore calendar configurations.

• Collaborate with Clinical Operations, Finance, Regulatory, and Study Teams regarding coverage determinations.

• Generate coverage analysis documentation, summary tables, and billing justification reports.

• Provide guidance to study teams on Medicare coverage regulations, billing risks, and best practices.

• Assist with internal and external audits.

• Keep track of CMS updates and industry best practices to enhance coverage analyses and study operations.

⛳️ Requirements

• Bachelor’s degree in Healthcare Administration, Medical Coding, Auditing, Finance, Accounting, Nursing, or a related discipline.

• At least 3 years of experience in Medicare Coverage Analysis supporting clinical research studies within an Academic Medical Center or health/hospital system.

• Familiarity with oncology clinical trial protocols.

• Strong knowledge of CMS guidelines, Medicare billing compliance, and the operations of clinical trials.

• Capability to work independently while managing multiple protocols and deadlines concurrently.

• Outstanding attention to detail, analytical capabilities, and problem-solving skills.

• Proficient written and verbal communication abilities.

• Aptitude for explaining complex billing concepts to non-technical audiences.

• Comfortable operating in a fully remote environment with distributed teams.

• Proficient in Microsoft Word, Excel, PowerPoint, Adobe, Teams, and SharePoint.

• Experience with OnCore calendar builds is preferred but not mandatory; training will be provided.

• Candidates must currently reside in the USA.

• Must respond to the employment visa sponsorship inquiry.

🏝️ Benefits

• 20 PTO days.

• 9 paid holidays.

• Company-paid life insurance.

• Short- and long-term disability coverage.

• 401(k) retirement plan.

• Comprehensive healthcare options.

• Fully remote work arrangement.

• Training provided for OnCore calendar builds.