Clinical Research Coverage Analyst

Saint Louis University • SLU Saint Louis, MO

1d • Onsite

About The Position

The Clinical Research Coverage Analyst provides education and training to the clinical research community of the School of Medicine regarding clinical research studies. This position contributes to compliant research billing practices by making determinations of qualifying clinical trial (QTC) status and performing detailed coverage analysis (CA). This position also promotes and supports accurate billing practices to be compliant with Medicare and third-party payment rules. Additionally, this position assists in streamlining research study activation and ensures compliance with federal/state and local regulations, as well as University guidelines.

Requirements

• Associate's degree
• Five years of related work experience
• Knowledge of regulations and guidelines related to clinical research
• Working knowledge of clinical research and multiple medical conditions
• Working knowledge of Medicare/Medical billing processes
• Organizational, analytical, and decision-making skills
• Excellent verbal and written communication skills
• Detail oriented with ability to independently research source materials and develop reasonable approaches to issues as they arise
• Ability to read and comprehend complex materials
• Ability to speak to groups, conduct educational sessions, and adapt teaching styles to learners
• Ability to operate computer and various software
• Ability to maintain confidentiality

Nice To Haves

• Bachelor's degree
• Three years of related work experience
• Previous experience completing Medicare Coverage Analysis
• Experience with research activity in an academic medical center
• CPT coding experience

Responsibilities

• Reviews clinical trial protocols to determine if each new study is a qualified clinical trial pursuant to CMS policy; creates a detailed Coverage Analysis using clinical trial documents to designate which procedures/services may be “routine care” and billable to patient insurance and which should be billed to the study sponsor based on relevant regulations and determinations; serves as National and Local Coverage Determination (NCD and LCD) subject matter expert; interfaces with study teams and sponsors to resolve discrepancies in specific protocol assessments; interfaces with study teams and principal investigators to assist with coverage analysis determinations; performs document review for alignment for each study
• Acts as liaison with partnering hospital to ensure each new study is built in the electronic medical record (EMR) system; submits build forms, maintains spreadsheet of builds, requests updates / corrections
• Provides education for clinical research within the University community; conducts training sessions and develops tools and standardized policies related to the conduct of clinical research; develops a training program for the University clinical research coordinators to conduct clinical research
• Assists with the management of clinical trials organization; attends meetings
• Performs other duties as assigned

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Associate degree