Remote Analyst for Clinical Trial Coverage

Job Overview

Join our esteemed organization as a Clinical Trial Coverage Analyst in a remote capacity. In this pivotal role, you will be responsible for orchestrating and overseeing billing analyses for clinical trials, ensuring meticulous compliance with Medicare and Medicaid regulations. You will collaborate effectively with research teams, healthcare providers, and various departments to facilitate the budgeting, billing, and compliance processes integral to clinical trials.

Key Responsibilities

• Develop comprehensive coverage analysis grids and execute both fundamental and intricate billing and budget analyses for clinical trials.
• Ensure all billing operations are in accordance with CMS regulations and Medicare billing practices.
• Collaborate with research teams and respective departments to conduct coverage analyses, guaranteeing that all documentation and processes adhere to ethical and legal standards.
• Utilize appropriate coding (CDM/CPT) to manage billing claims and appropriately differentiate research-related charges.
• Partner with budget and contract teams to ensure seamless billing coordination for clinical trials.
• Employ systems such as Epic and HPM Explorer to track and manage clinical trial billing, including the establishment of research fee schedules and conducting monthly compliance audits.
• Serve as a liaison between study teams, vendors, and various departments to facilitate effective communication and execution of billing processes.
• Investigate and apply relevant federal and state guidelines to uphold compliance across clinical trials.
• Identify discrepancies, resolve invoice complications, and ensure precise charge segregation for each study.
  
  

Required Skills

• Ability to work autonomously with minimal oversight.
• Strong analytical capabilities and meticulous attention to detail, particularly in navigating complex billing systems.
• Excellent communication skills, enabling effective coordination with a diverse range of stakeholders.
• Proficient in managing clinical research budgets and billing processes through clinical trial management software.
  
  

Qualifications

• Bachelor's degree in Healthcare Administration, Medical Coding, Auditing, Finance, Accounting, Nursing, or a related field (or equivalent experience).
• A minimum of four (4) years of experience in clinical research, emphasizing billing, budgeting, or regulatory compliance.
• Certification in Healthcare Research Compliance or Epic systems is preferred.
• Strong familiarity with CMS regulations, Medicare billing practices, and clinical trial management software.
• Experience with electronic administrative systems such as Grant.gov, CICERO, OnCore, or Epic is advantageous.
  
  

Career Growth Opportunities

This position offers significant opportunities for professional development, allowing you to enhance your skills and advance your career within the clinical research field.

Company Culture And Values

Our organization is committed to fostering a culture of integrity, excellence, and collaboration. We value diversity and strive to create a supportive environment that encourages innovation and professional growth.

Employment Type: Full-Time