Coverage Analyst
- 📅
- 14351-TBE Requisition #
Thanks for your interest in the Coverage Analyst position.
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Basic education, experience and skills required for consideration:
- Bachelor’s Degree or equivalent combination of education and experience.
- Two years of experience working in research administration, a Contract Research Organization, pharma or biotech industry, a medical or clinical practice arena, or health insurance industry
- Must have working knowledge of clinical trials
- Must be familiar with HCPCS / CPT, DRG coding
- Must understand what is typically considered standard of care or routine care and what is considered research-related in the context of a clinical trial
- Must be familiar with Medicare regulations, guidelines, policies (especially the CMS Clinical Trial Policy, also known as NCD 310.1) as they pertain to clinical research billing
- Working knowledge of CAR T processes / therapies and other immunotherapy processes is desirable
- Must have analytical skills to develop and review coverage analyses and clinical trial documentation based on established criteria and departmental guidelines
- Must have research skills to review large amounts of coverage guidance from multiple sources, with the ability to apply information appropriately and efficiently to each billing grid developed
- Must have excellent interpersonal skills to deal with complex, sensitive, and confidential material with Principal Investigators, sponsors, and administrative and management personnel
- Must be able to manage multiple competing demands
- Must be able to proactively negotiate priorities
- Must demonstrate consistent and successful follow through on issues and problems
- Understanding of Institutional Review Board purposes and requirements
- Knowledge of Clinical Research Finance and/or Revenue Cycle operations (specifically claims processing workflows and procedures)
- Must have excellent written and oral communication skills
- Must have ability to work independently while still serving as a member of a professional team
- Demonstrate strong attention to detail
- Must be able to proofread documents
- Must be able to research information
Preferred education experience and skills:
- Coding (HCPCS/CPT; DRG); related to Oncology to a plus
- Experience budgeting and estimating clinical trials costs is a plus
- Experience in an academic research environment
- Knowledge of Good Clinical Practice Guidelines, ICH Guidelines, FDA and HIPAA regulations, Medicare Clinical Trial Policy
- Knowledge of common budgeting practices and general time/effort allotments is a plus
- Clinical trial coverage analysis development; clinical trial billing and/or clinical trial billing compliance
- Clinical Research Coordination and/or Nursing
Preferred Certification/Licensure:
- Certified Clinical Research Coordination (CCRC)
- Certified Clinical Research Associate (CCRA)
- Registered Health Information Administrator (RHIA)
- Registered Health Information Technician (RHIT)
City of Hope is committed to creating a
diverse environment and is proud to be an equal opportunity employer. All qualified applicants will receive
consideration for employment without regard to race, religion, color, national
origin, sex, sexual orientation, gender identity, age, status as a protected
veteran, or status as a qualified individual with disability.
