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Research Coverage Analyst

2 months ago

Evanston, United States Medix™ Full time

We are looking for an experienced MCA to join a growing medical group. This position is hybrid with 3 days in office and 2 remote days.


What You Will Do


  • Reviews clinical trial proposals/protocols to determine if each new study is a qualified clinical trial pursuant to CMS policy; creates coverage analysis & billing plan for each clinical trial in accordance with Medicare rules and performs document review for alignment for each study.
  • Reviews, prepares, and generates detailed Coverage Analysis using clinical trial documents (i.e., protocol, research intake form, contract, informed consent) to determine if items/services provided for the study are deemed qualified as a clinical trial pursuant to the Medicare Clinical Trial Policy 310.1, National and Local Coverage Determination or otherwise approved by CMS.
  • Assesses compliance with other regulatory requirements
  • Participates in study specific team meetings to build relationships with research teams and administrators to support and facilitate clinical research study activation, budget development, informed consent review and guidance, and CTMS navigation
  • Maintains required competencies and current knowledge in relevant research billing rules and guidance, database management, Outlook, and Excel
  • Assists with Office of Clinical Research special projects as needed.