Senior Medicare Coverage Analyst

Title: Senior Medicare Coverage Analyst

Location: Lexington United States

Job Description:

Job Summary

Shape the Future of Clinical Research Administration at the University of Kentucky

Wildcat Wisdom, Kentucky Innovation - Supporting Discoveries, Transforming Outcomes!

Why Join Us?

The University of Kentucky's Clinical Research Support Office (CRSO) is seeking a dedicated and skilled Medicare Coverage Analyst Sr (Clinical Trials Coverage Analyst Sr). This vital role supports and enables groundbreaking clinical research across the University.

About the Role:

This position is eligible to be fully remote.

This position performs detailed reviews of complex study protocols, budgets, informed consent forms, contracts, FDA documents, and other relevant study documents to determine qualifying status according to Medicare Clinical Trial Policy, and conducts a comprehensive coverage analysis for all applicable study protocols across the enterprise. It determines what items of service are billable after reviewing Medicare Benefits Policy, relevant National Coverage Decisions (NCDs), Local Coverage Decisions (LCDs), Code of Federal Regulations, state law, professional practice guidelines, and, when necessary, consulting with the Medicare Administrative Contractor (MAC) for the region. This role is responsible for developing and delivering professional coverage analysis and financial calendars where the coverage analysis is not applicable, according to national patient care services billing standards. The position will provide guidance to study teams about proper coding and billing for procedures in the Epic system within the context of clinical research and based on the state and national standards. The role is responsible for following the UK established policies for patient care services, including documentation in the medical record and documenting coverage analysis justifications.

Under the direct supervision of the Director of Clinical Research Administration and Billing Integrity, the Research Coverage Analyst helps develop and refine processes to integrate the coverage analysis workflow with UKHC and UK related processes and teams. The role performs its work collaboratively with investigators, study teams, clinical research coordinators, and other research staff while serving as a resource on coverage analysis as an integral component to maintaining proper billing integrity and compliant standards. This role will also cross-train on clinical trial budget development and charge review process.

The University of Kentucky uses equivalencies in determining if a potential applicant meets the minimum education and experience. Related experience can be substituted for education. Click here for more information about equivalencies: http://www.uky.edu/hr/employment/working-uk/equivalencies

Why Clinical Research Professionals Choose University of Kentucky

• Top 10% of Academic Medical Centers Nationwide: Recognized as a leader in research excellence and innovation.
• Forbes' Best Large Employers: Ranked among the Top 100 Employers Nationwide in 2024 and named one of Kentucky's Best Employers on Forbes' America's Best-In-State Employers list.
• 1 of 34 Universities Nationwide: Holds the prestigious trifecta of research designations in cancer, aging, and translational science.
• Flexible Remote Work Options: Enjoy the convenience of fully remote or hybrid roles while supporting groundbreaking research.
• Professional Development Opportunities: Engage in interdisciplinary collaborations, virtual conferences, and training programs to advance your career.

Want to learn more about the Department?

The Clinical Research Support Office (CRSO) provides support to investigators and study teams conducting clinical research, including clinical trials. Services provided by the CRSO include maintaining a clinical trial management system (CTMS), conducting coverage analysis, developing study budgets, negotiating payment terms with sponsors, and regulatory services. More information can be found at: https://research.uky.edu/clinical-research-support-office.

Interested in what UK Benefits have to offer?

The University of Kentucky is proud to offer a benefits package that helps us recruit and retain the very best faculty and staff. In addition to your take-home pay, your benefits package is a major component of your total compensation at UK. These benefits include our 200 percent match on eligible retirement contributions; competitive health, dental, and vision coverage; tuition benefits for classes at UK, and much more. To learn more about these benefits, please visit: https://hr.uky.edu/employment/our-benefits.

Ready to Make a Difference in Clinical Research Administration?

Are you ready to take the next step in advancing clinical research and innovation? Join us in UK's Clinical Research Support Office as the next dedicated Medicare Coverage Analyst Sr (Clinical Trials Coverage Analyst Sr) and play a pivotal role in supporting groundbreaking projects that shape the future.

Driving Clinical Research Excellence - Apply Today!

Skills / Knowledge / Abilities

Clinical Trial Protocol knowledge, medical coding or billing, medical terminology, attention to detail, ability to work independently, collaboration, strong competency in Microsoft Office programs, detailed understanding of the Epic billing system, proficient in OnCore MCA and Calendar consoles

Does this position have supervisory responsibilities? No Preferred Education/Experience

It is preferred that the candidate have work experience in a clinical setting that includes research coverage analysis, clinical research budgeting, clinical research management, and/or medical coding or billing. Candidates with coding knowledge in specific disease areas including oncology, cardiology, neurology, etc. are preferred.

CA certification or training in OnCore, Epic or coding is also preferred.

We value the well-being of each of our employees and are dedicated to creating a healthy place for everyone to work, learn and live. In the interest of maintaining a safe and healthy environment for our students, employees, patients and visitors, the University of Kentucky is a Tobacco & Drug Free campus.

The University follows both the federal and state Constitutions as well as all applicable federal and state laws on nondiscrimination. The University provides equal opportunities for qualified persons in all aspects of institutional operations and does not discriminate on the basis of race, color, national origin, ethnic origin, religion, creed, age, physical or mental disability, veteran status, uniformed service, political belief, sex, sexual orientation, gender identity, gender expression, pregnancy, marital status, genetic information or social or economic status.

Any candidate offered a position may be required to pass pre-employment screenings as mandated by University of Kentucky Human Resources. These screenings may include a national background check and/or drug screen.