Senior Clinical Trial Coverage Analyst

Company Description

Position requirements are non-negotiable. Must know how to build Coverage Analysis for clinical trials.

     This position is 100% remote and does not require any travel

The University of Maryland Medical System (UMMS) serves more than one million patients and families every year. More than 29,000 employees and 4,600 providers work at UMMS. Each and every one of these individuals – from the patients we care for, the family members we reassure to our colleagues that we champion – represent the amazingly vibrant communities we serve. And we continue to seek out qualified candidates who reflect the values, backgrounds and stories of our neighbors and patients. We want to hear your voice, learn from your experiences, and be shaped by your insight as part of our workforce. After all, when we come together from different walks of life, we become stronger, better, and more empathetic.

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.

This position provides guidance and support to the Clinical Trial Analysts, and acts as a subject matter expert on coverage analysis, CMS regulations, as well as local and federal coverage determinations.

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 analysis.
•  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 parties.
• Performs basic and complex billing and budget analysis in accordance with …