Senior Clinical Trial Coverage Analyst

2-4 years

Not Disclosed

Remote, USA

10 Aug. 2, 2024

Job Description

Job Type: Full Time Remote Education: B.Sc./ M.Sc./ M.Pharm/ B.Pharm/ Life Sciences Skills: Causality Assessment, Clinical SAS Programming, Communication Skills, GCP guidelines, ICD-10 CM Codes, CPT-Codes, HCPCS Codes, ICD-10 CM, CPT, HCPCS Coding, ICH guidelines, ICSR Case Processing, Interpersonal Skill, Labelling Assessment, MedDRA Coding, Medical Billing, Medical Coding, Medical Terminology, Narrative Writing, Research & Development, Technical Skill, Triage of ICSRs, WHO DD Coding

Position Title: Coverage Analysis Specialist (Remote)

Company: University of Maryland Medical System (UMMS)
Location: Remote (No Travel Required)

Compensation: Competitive Salary

Company Overview:

The University of Maryland Medical System (UMMS) is dedicated to serving over one million patients annually. With a workforce of more than 29,000 employees and 4,600 providers, UMMS is committed to reflecting the diverse values and backgrounds of the communities we serve. We welcome candidates who bring varied experiences and perspectives to our dynamic team.

Position Summary:

Under limited supervision, the Coverage Analysis Specialist will manage and coordinate the creation of billing analyses for clinical trials in compliance with CMS regulations and clinical trial policies. This remote position involves working closely with investigators, research teams, and healthcare providers to ensure accurate billing and budgeting for research services.

Key Responsibilities:

Develop and analyze coverage analysis grids for clinical trials, ensuring compliance with Medicare billing rules.
Research and apply policies from federal, state, and institutional sources to coverage analysis.
Create grids and schedules of events for coverage analysis, including identifying and justifying billable items.
Apply appropriate CDM and CPT codes for research-related charges and assist in managing claims and budgeting.
Collaborate with research teams and facilitate clinical trial management processes.
Serve as a liaison between clinical research teams, healthcare providers, and other stakeholders.
Research regulations and compliance guidelines related to Medicare, OIG, FDA, and other relevant standards.
Coordinate with coverage analysis vendors, tracking progress and reporting results.
Address invoice discrepancies with the Central Billing Office and assist with charge segregation.
Develop fee schedules in Epic and manage research study records.
Organize internal reviews to ensure accuracy of coverage analysis and charge segregation.
Provide expert guidance on coverage analysis and research billing compliance.

Qualifications:

Education: Bachelor’s degree in Healthcare Administration, Medical Coding, Auditing, Finance, Accounting, Nursing, or a related field.
Experience: Four (4) years of clinical research experience required, with at least two (2) years specifically in developing coverage analysis and charge segregation for clinical trials.
Preferred Certification: Healthcare Research Compliance or Epic certification.
Skills:
- In-depth knowledge of clinical trial management, billing compliance, and regulations.
- Proficiency with electronic administration software (e.g., Grant.gov, CICERO, OnCore, Epic).
- Advanced skills in Microsoft Excel, databases, and other relevant software.
- Strong communication and problem-solving skills, with the ability to work independently in a matrix environment.
- Familiarity with current billing practices and regulations.

How to Apply:

To apply for this position, please submit your resume and cover letter outlining your qualifications and experience.

The University of Maryland Medical System is an Equal Opportunity Employer and values diversity in our workforce. We encourage individuals from all backgrounds to apply.

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Senior Clinical Trial Coverage Analyst

Job Description

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