Clinical Trial Coverage Analyst
Salary undisclosed
Checking job availability...
Original
Simplified
Company Description
Job Description
General Summary
Under limited supervision, and with the latitude for initiative and independent judgment,
performs, coordinates, and manages the creation and outsourcing of billing analysis in
accordance with the Center for Medicaid and Medicare Services (CMS) regulations and the Clinical Trial Policy for all clinical trials. The billing analysis must be compliant with the
Medicare billing rules. This position also serves as liaison with the investigators, research teams, healthcare providers, budgeting and contracting offices at UMMS and UMB, and in coordination with departmental clinical trial management processes. This position works with various systems including Epic and HPM Explorer for the purpose of segregating charges to ensure compliant billing for research services as well as providing pricing for budgeting purposes.
Principal Responsibilities And Tasks
The following statements are intended to describe the general nature and level of work being performed by people assigned to this classification. These are not to be construed as an exhaustive list of all job duties performed by personnel so classified.
and clinics.
designations.
identifying items that are to be billed to the sponsor via the budgeting and contract teams
at the Office of Research and Development (ORD) at University of Baltimore (UMB).
including computer search modalities.
Education and Experience
All your information will be kept confidential according to EEO guidelines.
Compensation:
- YOU MUST HAVE EXPERIENCE IN BUILDING COVERAGE ANALYSIS FOR CLINICAL TRIALS, TO BE CONSIDERED FOR THIS OPPORTUNITY**
Job Description
General Summary
Under limited supervision, and with the latitude for initiative and independent judgment,
performs, coordinates, and manages the creation and outsourcing of billing analysis in
accordance with the Center for Medicaid and Medicare Services (CMS) regulations and the Clinical Trial Policy for all clinical trials. The billing analysis must be compliant with the
Medicare billing rules. This position also serves as liaison with the investigators, research teams, healthcare providers, budgeting and contracting offices at UMMS and UMB, and in coordination with departmental clinical trial management processes. This position works with various systems including Epic and HPM Explorer for the purpose of segregating charges to ensure compliant billing for research services as well as providing pricing for budgeting purposes.
Principal Responsibilities And Tasks
The following statements are intended to describe the general nature and level of work being performed by people assigned to this classification. These are not to be construed as an exhaustive list of all job duties performed by personnel so classified.
- Creates coverage analysis grids and analyzes the performance of the actual coverage
- Performs basic and complex billing and budget analysis in accordance with CMS
and clinics.
- Applies CMS regulations, FDA guidance, and ethical policies when performing coverage
- Develops the coverage analysis including reviewing each potentially billable item within
designations.
- Applies the appropriate CDM and/or CPT codes for potentially billable items in the
identifying items that are to be billed to the sponsor via the budgeting and contract teams
at the Office of Research and Development (ORD) at University of Baltimore (UMB).
- Collaborates with research teams in performing the coverage analysis, as well as
- Researches and applies regulations and law related to Medicare regulations, OIG
including computer search modalities.
- Synchronizes the final coverage analysis with appropriate final study documents.
- Triages coverage analysis requests to our coverage analysis vendor when applicable. Acts as the intermediary between the vendor and the study teams during coverage analysis creation, tracks progress, and reports results.
- Researches and applies policies, guidance and guidelines from various sources including federal, state, UMMS and the University of Maryland Baltimore (UMB).
- Responsible for the dissemination of relevant documents and information to various
- Serves as liaison and contact with the clinical research teams and healthcare providers.
- Segregates charges in Epic by distinguishing research charges billed to the study versus
- Reviews and resolves invoice discrepancies with the Central Billing Office and the study
- Creates Epic RSH Records and Fee Schedules for each research study.
- Performs monthly coverage analysis and charge segregation audits to ensure ongoing
- Other duties as assigned.
Education and Experience
- Bachelor’s degree in Healthcare Administration, Medical Coding, Auditing, Finance, Accounting, Nursing, or a related field required.
- Four (4) years of clinical research experience required. Additional experience may be substituted for the educational requirement on a year-for-year basis for up to four (4) years.
- Certification in Healthcare Research Compliance or Epic preferred.
- Knowledge of principles and practices pertaining to developing and administering a clinical trial in compliance with sponsor, federal, state, UMMS and University of Maryland Baltimore regulations.
- Demonstrated skill tracking clinical and corporate contracts using electronic administration software such as Grant.gov, CICERO, OnCore, Epic, etc.
- Skill in cost/financial accounting and clinical trial management software.
All your information will be kept confidential according to EEO guidelines.
Compensation:
- Pay Range: $38.21-$45.9
- Other Compensation (if applicable):
- Review the 2024-2025 UMMS Benefits Guide
Company Description
Job Description
General Summary
Under limited supervision, and with the latitude for initiative and independent judgment,
performs, coordinates, and manages the creation and outsourcing of billing analysis in
accordance with the Center for Medicaid and Medicare Services (CMS) regulations and the Clinical Trial Policy for all clinical trials. The billing analysis must be compliant with the
Medicare billing rules. This position also serves as liaison with the investigators, research teams, healthcare providers, budgeting and contracting offices at UMMS and UMB, and in coordination with departmental clinical trial management processes. This position works with various systems including Epic and HPM Explorer for the purpose of segregating charges to ensure compliant billing for research services as well as providing pricing for budgeting purposes.
Principal Responsibilities And Tasks
The following statements are intended to describe the general nature and level of work being performed by people assigned to this classification. These are not to be construed as an exhaustive list of all job duties performed by personnel so classified.
and clinics.
designations.
identifying items that are to be billed to the sponsor via the budgeting and contract teams
at the Office of Research and Development (ORD) at University of Baltimore (UMB).
including computer search modalities.
Education and Experience
All your information will be kept confidential according to EEO guidelines.
Compensation:
- YOU MUST HAVE EXPERIENCE IN BUILDING COVERAGE ANALYSIS FOR CLINICAL TRIALS, TO BE CONSIDERED FOR THIS OPPORTUNITY**
Job Description
General Summary
Under limited supervision, and with the latitude for initiative and independent judgment,
performs, coordinates, and manages the creation and outsourcing of billing analysis in
accordance with the Center for Medicaid and Medicare Services (CMS) regulations and the Clinical Trial Policy for all clinical trials. The billing analysis must be compliant with the
Medicare billing rules. This position also serves as liaison with the investigators, research teams, healthcare providers, budgeting and contracting offices at UMMS and UMB, and in coordination with departmental clinical trial management processes. This position works with various systems including Epic and HPM Explorer for the purpose of segregating charges to ensure compliant billing for research services as well as providing pricing for budgeting purposes.
Principal Responsibilities And Tasks
The following statements are intended to describe the general nature and level of work being performed by people assigned to this classification. These are not to be construed as an exhaustive list of all job duties performed by personnel so classified.
- Creates coverage analysis grids and analyzes the performance of the actual coverage
- Performs basic and complex billing and budget analysis in accordance with CMS
and clinics.
- Applies CMS regulations, FDA guidance, and ethical policies when performing coverage
- Develops the coverage analysis including reviewing each potentially billable item within
designations.
- Applies the appropriate CDM and/or CPT codes for potentially billable items in the
identifying items that are to be billed to the sponsor via the budgeting and contract teams
at the Office of Research and Development (ORD) at University of Baltimore (UMB).
- Collaborates with research teams in performing the coverage analysis, as well as
- Researches and applies regulations and law related to Medicare regulations, OIG
including computer search modalities.
- Synchronizes the final coverage analysis with appropriate final study documents.
- Triages coverage analysis requests to our coverage analysis vendor when applicable. Acts as the intermediary between the vendor and the study teams during coverage analysis creation, tracks progress, and reports results.
- Researches and applies policies, guidance and guidelines from various sources including federal, state, UMMS and the University of Maryland Baltimore (UMB).
- Responsible for the dissemination of relevant documents and information to various
- Serves as liaison and contact with the clinical research teams and healthcare providers.
- Segregates charges in Epic by distinguishing research charges billed to the study versus
- Reviews and resolves invoice discrepancies with the Central Billing Office and the study
- Creates Epic RSH Records and Fee Schedules for each research study.
- Performs monthly coverage analysis and charge segregation audits to ensure ongoing
- Other duties as assigned.
Education and Experience
- Bachelor’s degree in Healthcare Administration, Medical Coding, Auditing, Finance, Accounting, Nursing, or a related field required.
- Four (4) years of clinical research experience required. Additional experience may be substituted for the educational requirement on a year-for-year basis for up to four (4) years.
- Certification in Healthcare Research Compliance or Epic preferred.
- Knowledge of principles and practices pertaining to developing and administering a clinical trial in compliance with sponsor, federal, state, UMMS and University of Maryland Baltimore regulations.
- Demonstrated skill tracking clinical and corporate contracts using electronic administration software such as Grant.gov, CICERO, OnCore, Epic, etc.
- Skill in cost/financial accounting and clinical trial management software.
All your information will be kept confidential according to EEO guidelines.
Compensation:
- Pay Range: $38.21-$45.9
- Other Compensation (if applicable):
- Review the 2024-2025 UMMS Benefits Guide