Clinical Research Financial Analyst

2 weeks ago

Yuma, Arizona, United States Acord (association For Cooperative Operations Research And Development) Full time

Work Status Details:
REGULAR FULL TIME | 80.00 Hours Every Two Weeks

Pay Rate Type:
Annual Salary

Location:
Remote

Listed is the base hiring salary range offered for this position. Actual salaries may vary depending on factors, including but not limited to skills and experience. The salary range listed is just one component of the total rewards/compensation package offered to candidates.
Min = $91,359.840
Mid = $118,767.792

Position Overview:


The Clinical Research Budget and Coverage Analyst plays a crucial role in evaluating clinical trial documentation to ascertain if the study qualifies under the guidelines set forth by the Center for Medicare and Medicaid Services (CMS). This position involves the creation and negotiation of research budgets, as well as the generation of a comprehensive coverage analysis and billing plan that adheres to payer regulations, followed by the development of an internal cost-based budget.


Key Responsibilities:


1. Analyze clinical trial documentation to determine eligibility as a qualifying clinical trial in accordance with CMS National Coverage Determination (NCD) 310.1, also referred to as the Medicare Clinical Trial Policy.

2. Assess study types and identify all protocol-required items and services.

3. Conduct and document coverage analyses and internal budgets for all clinical research initiatives, irrespective of funding sources (e.g., industry, government, or other identified funding sources).

4. Establish clinical trial qualifications.

5. Identify appropriate payer sources for clinical trial items and services, ensuring compliance with Medicare coverage rules to guarantee accurate billing for research-related activities.

6. Develop a thorough internal cost-based budget for all items and services that cannot be billed to insurance, ensuring that costs associated with research activities are fully recovered through sponsors or other funding sources.

7. Collaborate with relevant ancillary departments regarding pricing as necessary.
8. Timely communicate identified funding gaps to the Institutional Research Director.
9. Update budget and coverage analyses in response to protocol or contract/budget amendments.
10. Provide coverage analyses to clinical research financial analysts to ensure proper payment from sponsors, patients, and/or third parties.
11. Offer guidance to clinical research regulatory coordinators regarding financial language in informed consent forms (ICF).

12. Support the development and implementation of institutional research billing policies, procedures, and standard operating procedures (SOP), along with training standards.

13. Maintain up-to-date knowledge of applicable Medicare and Medicaid reimbursement guidelines and payer requirements, informing the institutional organization as necessary.

14. Stay informed about research coding regulations related to the Medicare Clinical Trial Policy and conduct training for the clinical research team as needed.

15. Serve as a knowledgeable resource for the clinical research team concerning Medicare and Medicaid policies and coverage.

16. Engage in continuing education to remain updated on new rules, regulations, and revisions set forth by CMS and other relevant entities regarding billing compliance.

17. Pursue professional growth through participation in continuing education programs.
Other duties as assigned.

Minimum Qualifications:
A Bachelor’s degree or higher in clinical health sciences is preferred, such as a Doctor of Pharmacy (Pharm.D) or a nursing degree from an accredited four-year nursing institution.

Three years of recent experience (or equivalent education) in clinical research or related fields, particularly in billing, coverage determinations, and budgeting, along with a solid understanding of research billing regulations.

One year of experience in basic accounting or finance functions is preferred.
Certification in SOCRA or ACRP (Certification should be achieved within 3 years in role).

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