Research Billing Coverage Analysis Coordinator

UNC Health•Chapel Hill, NC

7d•Remote

About The Position

The Research Billing Coverage Analysis Coordinator analyzes protocol-driven clinical research services to ensure routine and research services are correctly identified and billed in compliance with the Medicare Clinical Trial Policy (NCD 310.1), applicable national and local laws and regulations, and institutional billing policies. Under limited supervision, the coordinator uses initiative and independent judgment to perform, coordinate, and manage the creation and outsourcing of billing analyses, applying subject matter expertise to complex protocols. The documented analysis supports study budget development and patient charge review after research subjects complete visits at UNC Health facilities. The coordinator meets with Principal Investigators and study teams to review billing grids before study startup and collaborates with those teams to assess readiness before activation. The role also works across research, finance, compliance, and billing stakeholders to support accurate billing practices and resolve complex research billing issues. The position is remote, based in Chapel Hill, North Carolina, and is a full-time day job with 40 standard hours per week.

Requirements

Bachelor's degree or equivalent.
With a bachelor's degree, one year of related experience is required.
Alternatively, with an associate's degree, five years of related experience is required.
Strong understanding of research billing compliance, coverage analysis, and clinical trial operations.
Ability to review and interpret complex research protocols, informed consent forms, sponsor agreements, Medicare benefit policies, and National and Local Coverage Determinations.
Experience with clinical research billing workflows, coverage analysis calendars, budget development, and cross-functional collaboration.
Highly detail-oriented and organized, with the ability to interpret ambiguous information and communicate clearly and effectively across teams.

Nice To Haves

Familiarity with CTMS platforms such as OnCore, Epic, and other healthcare or research systems.
Working knowledge of CPT/HCPCS coding concepts and clinical trial startup processes.
Background in clinical research coordination, research administration, nursing or allied health, research finance, or healthcare revenue cycle operations.

Responsibilities

Review research protocols, sponsor agreements, informed consent forms, and related documents.
Analyze Medicare benefit policies, National and Local Coverage Determinations, and medical treatment guidelines relevant to study interventions and routine care.
Create coverage analyses in accordance with Medicare's Clinical Trial Policy (NCD 310.1), and assist clinical department research staff in interpreting guidance and its effect on research billing.
Apply appropriate Hospital and/or CPT codes to potentially billable items in coverage analyses to support claims review, and identify items to be billed to the sponsor through budgeting and contract teams.
Collaborate with trial Principal Investigators and study team members to clarify procedures that are unclear in study documents or involve differing coverage opinions.
Work with research teams to conduct thorough feasibility assessments using available tools.
Assist in creating study budgets and ensure clinical study treatment costs are included and appropriately and accurately represented.
Assist audit and compliance departments during reviews and monitoring of clinical research billing.
Prepare clear documentation of coverage determinations, including supporting citations and compliant, accurate categorization of all items and services.
Serve as a liaison with the UNC Health Integrated Billing Office, identify best practices, and oversee resolution of complex research billing issues.
Resolve billing questions from the UNC Health Billing Office in a timely manner when a patient's record is on bill hold.
Perform other duties assigned by management to meet business needs.