Description
We are seeking a dedicated and detail-oriented Medicare Coverage Analyst and Billing Compliance Specialist to join our team in a remote role. You will play a crucial part in ensuring compliance in our oncology clinical research billing processes. Your expertise will contribute to improving the quality of life and survival for cancer patients through access to innovative clinical trials.
About Us
As the largest network dedicated to early-phase oncology clinical research, we provide hope to patients by offering access to cutting-edge trials across the US and Europe. With over 1,300 studies completed and numerous FDA/EMA approvals, our mission is to accelerate the development of new anticancer drugs while ensuring that patients in community practices can benefit from these advancements.
Key Responsibilities
- Compliance Oversight: Manage and maintain a comprehensive program to oversee, educate, and support all clinical research areas involved in budgeting and billing, ensuring compliance with relevant laws and regulations.
- Regulatory Knowledge: Stay informed about CMS and FDA regulations related to Medicare coverage analysis, as well as other laws pertaining to clinical trials, including the Federal Anti-Kickback laws and HIPAA.
- Document Review: Conduct thorough compliance reviews of research study billing documents, including budgets, coverage analyses, protocols, contractual terms, and informed consent.
- Billing Grid Finalization: Review and finalize study billing grids, ensuring that coverage analysis decisions are accurately documented.
- Audits and Recommendations: Perform research billing audits to ensure adherence to federal, state, and local regulations, as well as institutional policies. Propose corrective actions for any identified deficiencies.
- Training Development: Collaborate with stakeholders to identify training needs and develop programs for clinical research staff, ensuring appropriate billing practices.
- Metrics and Improvements: Assist in creating metrics for ongoing assessment and work closely with teams to identify opportunities for enhancing clinical research billing practices.
- Policy Development: Contribute to the creation of policies and procedures, monitor key performance indicators, and manage various projects related to clinical research budget and billing.
- Data Quality Control: Assist with data quality checks to ensure accuracy across multiple systems (OnCore, Veeva, ARIA, etc.).
Qualifications
- Bachelor's degree
- Medicare Coverage Analysis trained, preferably certified
- At least 2 years of relevant experience
- Excellent communication skills with strong analytical abilities and attention to detail
- Commitment to maintaining privacy and confidentiality of sensitive information
Compensation And Benefits
The annual base salary for this role ranges from \(72,000 to \)89,000, depending on factors such as market location, experience, and skills. We offer a competitive compensation package along with a comprehensive benefits program, including:
- Health Coverage: Medical, dental, and vision insurance
- Retirement Planning: 401(k) plan with employer matching
- Financial Security: Life and disability insurance
- Flexible Options: Health savings and flexible spending accounts
- Work-Life Balance: Paid time off, flexible schedules, and remote work options
We foster an inclusive and collaborative work environment where all employees feel valued and empowered to contribute to our mission.
Join Our Mission
Are you ready to be part of a team that is transforming the future of cancer treatment? We invite you to apply and contribute your expertise to bring hope and healing to patients worldwide.
We are an equal opportunity employer committed to diversity in the workplace and do not discriminate based on any protected status.
Employment Type: Full-Time