Clinical Research Coverage Analyst
Core
Subject matter expert for Medicare Coverage Analysis (MCA), Qualifying Clinical Trial (QCT/QTC) determinations, and clinical trial billing compliance within an academic medical center.
Role type
Senior Clinical Research Coverage Analyst
Builds
Compliant billing pathways and study activation processes for clinical trials
Domain
Healthcare + Clinical Research Operations
Deliverable
production ML models | product features | dashboards & analysis | client delivery | infrastructure | physical/clinical work
Required skills
Medicare Coverage Analysis (MCA), Qualifying Clinical Trial (QCT/QTC) determination, clinical trial billing compliance, regulatory interpretation (CMS/GCP), study documentation review, stakeholder collaboration, training development
Preferred skills
CPT/ICD/HCPCS coding, EMR system proficiency, clinical trial budgeting, CCRP/CCRC certification, academic medical center experience
Technologies
Microsoft Office, EMR systems
Responsibilities
Review protocols and contracts to determine QCT/QTC status; conduct MCAs to identify routine vs. research costs; determine billing designations and payment responsibilities; serve as SME on NCDs/LCDs; collaborate with investigators to resolve coverage issues; develop training materials on billing compliance; support study activation in EMR systems.
Seniority
Senior, hands-on IC
