Actalent
Medicare Coverage Analyst
Actalent, Seattle, Washington, us, 98127
Job Title: Clinical Trial Coverage Analyst
Job Description
We are seeking a Clinical Trial Coverage Analyst to join our pre-award team. The primary responsibility is to conduct comprehensive coverage analysis by harmonizing clinical trial protocols, budgets, contracts, and informed consent documents to determine billable items to insurance, based on federal and state billing regulations, including Medicare's National Coverage Decision (NCD) 310.1. This role requires a keen understanding of clinical research and the ability to work closely with various departments to ensure regulatory and budgetary compliance.
Responsibilities
Review clinical research trials to determine qualification under Medicare's National Coverage Determination 310.1 (NCD).
Create coverage analysis based on clinical trial protocols and related regulatory documents.
Outline billing of clinical items and services required by the research study.
Communicate coverage analysis results effectively to Principal Investigators and study teams.
Interpret research contracts, study budgets, clinical protocols, and consent forms to extrapolate billing/coverage data.
Essential Skills
3+ years of recent coverage analysis experience.
Ability to think critically and understand complex protocols.
Proficiency in Excel for building analysis templates.
Strong reading comprehension skills.
Resourcefulness, humility, flexibility, and the ability to accept feedback.
Additional Skills & Qualifications
Proficiency with medical terminology.
Knowledge of clinical research, including commercial, federal, and PI-initiated protocols.
Experience with clinical trials research activities, regulatory compliance, and IRB informed consent guidelines.
Work Environment
This is a fully remote position, requiring work in the PST time zone. The team is highly communicative, utilizing constant contact via Teams to collaborate and support one another. The environment values honesty, trust, and adaptability, with a strong emphasis on being available and communicative during work hours.
About Actalent
Actalent is a global leader in engineering and sciences services and talent solutions. We help visionary companies advance their engineering and science initiatives through access to specialized experts who drive scale, innovation and speed to market. With a network of almost 30,000 consultants and more than 4,500 clients across the U.S., Canada, Asia and Europe, Actalent serves many of the Fortune 500.
Diversity, Equity & Inclusion
At Actalent, diversity and inclusion are a bridge towards the equity and success of our people. DE&I are embedded into our culture through:
Hiring diverse talent
Maintaining an inclusive environment through persistent self-reflection
Building a culture of care, engagement, and recognition with clear outcomes
Ensuring growth opportunities for our people
The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.
If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing process due to a disability, please email actalentaccommodation@actalentservices.com (%20actalentaccommodation@actalentservices.com) for other accommodation options.
Job Description
We are seeking a Clinical Trial Coverage Analyst to join our pre-award team. The primary responsibility is to conduct comprehensive coverage analysis by harmonizing clinical trial protocols, budgets, contracts, and informed consent documents to determine billable items to insurance, based on federal and state billing regulations, including Medicare's National Coverage Decision (NCD) 310.1. This role requires a keen understanding of clinical research and the ability to work closely with various departments to ensure regulatory and budgetary compliance.
Responsibilities
Review clinical research trials to determine qualification under Medicare's National Coverage Determination 310.1 (NCD).
Create coverage analysis based on clinical trial protocols and related regulatory documents.
Outline billing of clinical items and services required by the research study.
Communicate coverage analysis results effectively to Principal Investigators and study teams.
Interpret research contracts, study budgets, clinical protocols, and consent forms to extrapolate billing/coverage data.
Essential Skills
3+ years of recent coverage analysis experience.
Ability to think critically and understand complex protocols.
Proficiency in Excel for building analysis templates.
Strong reading comprehension skills.
Resourcefulness, humility, flexibility, and the ability to accept feedback.
Additional Skills & Qualifications
Proficiency with medical terminology.
Knowledge of clinical research, including commercial, federal, and PI-initiated protocols.
Experience with clinical trials research activities, regulatory compliance, and IRB informed consent guidelines.
Work Environment
This is a fully remote position, requiring work in the PST time zone. The team is highly communicative, utilizing constant contact via Teams to collaborate and support one another. The environment values honesty, trust, and adaptability, with a strong emphasis on being available and communicative during work hours.
About Actalent
Actalent is a global leader in engineering and sciences services and talent solutions. We help visionary companies advance their engineering and science initiatives through access to specialized experts who drive scale, innovation and speed to market. With a network of almost 30,000 consultants and more than 4,500 clients across the U.S., Canada, Asia and Europe, Actalent serves many of the Fortune 500.
Diversity, Equity & Inclusion
At Actalent, diversity and inclusion are a bridge towards the equity and success of our people. DE&I are embedded into our culture through:
Hiring diverse talent
Maintaining an inclusive environment through persistent self-reflection
Building a culture of care, engagement, and recognition with clear outcomes
Ensuring growth opportunities for our people
The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.
If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing process due to a disability, please email actalentaccommodation@actalentservices.com (%20actalentaccommodation@actalentservices.com) for other accommodation options.