- Creates coverage analysis grids and analyzes the performance of the actual coverage analysis.
- Researches and applies policies, guidance and guidelines from various sources including federal, state, UMMS and the University of Maryland Baltimore (UMB).
- Responsible for the dissemination of relevant documents and information to various parties.
- Performs basic and complex billing and budget analysis in accordance with CMS regulations for all clinical trials performed at UMMS affiliates and FPI practice offices and clinics.
- Applies CMS regulations, FDA guidance, ethical policies when performing coverage analysis.
- Develops grids/schedule of events to serve as the basis for the coverage analysis.
- Develops the coverage analysis including reviewing each potentially billable item within the clinical trial and citing specific resources for justification of the appropriate designations.
- Applies the appropriate CDM and/or CPT codes for potentially billable items in the coverage analysis in order to assist in the management of claims review, as well as identifying items that are to be billed to the sponsor via the budgeting and contract teams at the Office of Research and Development (ORD) at University of Baltimore (UMB).
- Collaborates with research teams in performing the coverage analysis, as well as facilitating the clinical trial management process involving UMB, UMMS, and FPI.
- Serves as liaison and contact with the clinical research teams and healthcare providers.
- Researches and applies regulations and law related to Medicare regulations, OIG regulations, FDA guidance, and related compliance documents using various resources including computer search modalities.
- Synchronizes the final coverage analysis with appropriate final study documents.
- Triages coverage analysis requests to our coverage analysis vendor when applicable. Acts as the intermediary between the vendor and the study teams during coverage analysis creation, tracks progress, and reports results.
- Assists as needed with segregation of charges in distinguishing research charges billed to the study versus those research charges that can be billed to insurance.
- Reviews and resolves invoice discrepancies with the Central Billing Office and the study teams,
- Creates Fee Schedules in Epic for each research study.
- Initiates request of RSH records in Epic for research studies after coverage analyses are completed
- Organizes monthly CA and charge segregation internal reviews with the clinical trial analysts to ensure accuracy.
- Serves as the subject matter expert for UMMS on coverage analysis creation and current research billing guidelines as well as research billing compliance
- Other duties as assigned.
- Bachelor's degree in Healthcare Administration, Medical Coding, Auditing, Finance, Accounting, Nursing, or a related field required.
- Four (4) years of clinical research experience required. Additional experience may be substituted for the educational requirement on a year-for-year basis for up to four (4) years.
- Two (2) years of additional experience working with developing coverage analysis for clinical trials as well as performing charge segregation for research participants.
- Certification in Healthcare Research Compliance or Epic preferred.
- Knowledge of principles and practices pertaining to developing and administering a clinical trial in compliance with sponsor, federal, state, UMMS and University of Maryland Baltimore regulations.
- Demonstrated skill tracking clinical and corporate contracts using electronic administration software such as , CICERO, OnCore, Epic, etc.
- Skill in cost/financial accounting and clinical trial management software.
- Expert knowledge of spreadsheets (i.e. Microsoft Excel), databases (i.e., DBASE, Microsoft Access), word processing programs (i.e., Microsoft Word), and graphic/specialty and other finance-related software programs.
- Highly effective verbal and written communication skills are necessary in dealing with a variety of healthcare and finance professionals including senior management staff.
- Ability to assess and evaluate complex financial data via use of computer analysis.
- Proficient organization and problem-solving skills are required to develop/implement efficient work processes. Ability to work effectively in a stressful work environment. Ability to work independently in a matrix work environment.
- Maintains familiarity with current regulations involved with compliant billing practices.
-
Analyst - Business Analyst II (Remote)
4 weeks ago
Cencora Baltimore, United StatesOur team members are at the heart of everything we do. At Cencora, we are united in our responsibility to create healthier futures, and every person here is essential to us being able to deliver on that purpose. If you want to make a difference at the center of health, come join ...
-
Remote Retirement Plan Compliance Analyst
1 week ago
Ascensus Baltimore, United StatesFuturePlan is the nations largest third-party administrator (TPA) of retirement plans, partnering with advisors in all 50 states. FuturePlan delivers the best of both worlds: high-touch personalized service from local TPAs backed by the strength and security of a large national f ...
-
Analyst - Business Analyst II (Remote)
3 weeks ago
Cencora Baltimore, United StatesOur team members are at the heart of everything we do. At Cencora, we are united in our responsibility to create healthier futures, and every person here is essential to us being able to deliver on that purpose. If you want to make a difference at the center of health, come join ...
-
Senior Clinical Trial Coverage Analyst, Remote
2 weeks ago
Vera Security Baltimore, United StatesSenior Clinical Trial Coverage Analyst, Remote · Full-time · Shift: Day · Location: Linthicum - 920 Elkridge Lndg · Position Type: Exempt · Position requirements are non-negotiable. Must know how to build Coverage Analysis for clinical trials. · This position is 100% remote and ...
-
Senior Clinical Trial Coverage Analyst, Remote
2 weeks ago
University of Maryland Medical System Baltimore, United StatesJob Description · Job DescriptionCompany Description · Position requirements are non-negotiable. Must know how to build Coverage Analysis for clinical trials. · This position is 100% remote and does not require any travel · The University of Maryland Medical System (UMMS) serves ...
-
Senior Clinical Trial Coverage Analyst, Remote
2 weeks ago
University of Maryland Medical System Baltimore, United StatesJob Description · Job Description Company Description · Position requirements are non-negotiable. Must know how to build Coverage Analysis for clinical trials. · This position is 100% remote and does not require any travel · The University of Maryland Medical System (UMMS) se ...
-
Senior Clinical Trial Coverage Analyst, Remote
2 weeks ago
University of Maryland Medical Center Baltimore Washington Baltimore, United StatesJob Description · General Summary · Under limited supervision, and with the latitude for initiative and independent judgment, performs, coordinates, and manages the creation and outsourcing of billing analysis in accordance with the Center for Medicaid and Medicare Services (CM ...
-
Senior Clinical Trial Coverage Analyst, Remote
2 weeks ago
University of Maryland Medical System Baltimore, United StatesJob Description · Job Description Company Description · Position requirements are non-negotiable. Must know how to build Coverage Analysis for clinical trials. · This position is 100% remote and does not require any travel · The University of Maryland Medical System (UMMS) serv ...
-
Clinical Trial Coverage Analyst, Remote
3 weeks ago
University of Maryland Medical System Linthicum, United StatesJob Description · Job DescriptionCompany Description · The University of Maryland Medical System (UMMS) serves more than one million patients and families every year. More than 29,000 employees and 4,600 providers work at UMMS. Each and every one of these individuals – from the p ...
-
Clinical Trial Coverage Analyst, Remote
2 weeks ago
University of Maryland Medical System Linthicum, United StatesJob Description · Job DescriptionCompany Description · **YOU MUST HAVE EXPERIENCE IN BUILDING COVERAGE ANALYSIS FOR CLINICAL TRIALS, TO BE CONSIDERED FOR THIS OPPORTUNITY** · The University of Maryland Medical System (UMMS) serves more than one million patients and families every ...
-
Remote Technology Analyst
6 days ago
Johns Hopkins Applied Physics Laboratory (APL) Laurel, MD, United States Part timeDo you enjoy working on challenging projects? · Are you skilled in customer service, problem solving and have a high attention to detail? · Do you desire to collaborate on groundbreaking projects? · We are seeking a Program Analyst to help us execute the Force Projection Sector' ...
-
Senior Clinical Trial Coverage Analyst, Remote
2 weeks ago
Vera Security BWI Airport, United StatesSenior Clinical Trial Coverage Analyst, Remote · Full-time · Shift: Day · Location: Linthicum - 920 Elkridge Lndg · Position Type: Exempt · Position requirements are non-negotiable. Must know how to build Coverage Analysis for clinical trials. · This position is 100% remote ...
-
Remote Technology Analyst
6 days ago
Johns Hopkins Applied Physics Laboratory (APL) Laurel, MD, United States Part timeDo you enjoy working on challenging projects? · Are you skilled in customer service, problem solving and have a high attention to detail? Do you desire to collaborate on groundbreaking projects? · We are seeking a Program Analyst to help us execute the Force Projection Sector 's ...
-
Senior Analyst, Media Analytics-Remote
1 week ago
Dentsu International Columbia, United StatesMerkle is a leading technology-enabled, data-driven customer experience management (CXM) company. For over 30 years, Fortune 1,000 companies and leading nonprofit organizations have partnered with us to build and maximize the value of their customer portfolios. · Job Description ...
-
Sr. Research Data Analyst
2 weeks ago
InsideHigherEd Baltimore, United States Administrative Jobs ,The Tobacco omics team at the Bloomberg School of Public Health is hiring a Sr. Research Data Analyst to provide research and analytic support on several projects. The Sr Research Data Analyst will work closely with the Principal Investigator. · Specific Duties & Responsibilities ...
-
Financial Analyst
2 weeks ago
Sudina Search Baltimore, United StatesProminent international company based in the Baltimore area, the recognized leader in its industry, seeks a Senior Project Financial Analyst for a 100% remote position. · Responsibilities Include · Reviewing and setting up new contractsEnsuring proper recordation of revenueAnal ...
-
Investment Analyst, Natural Resources
2 weeks ago
T. Rowe Price Baltimore, United StatesInvestment Analyst, Natural Resources (Agriculture or Chemicals) page is loaded · Investment Analyst, Natural Resources (Agriculture or Chemicals) · Apply · locations · Baltimore, MD · time type · Full time · posted on · Posted 2 Days Ago · job requisition id · 71330 · ...
-
Healthcare Analyst
1 week ago
ALTA IT Services, LLC Baltimore, United StatesALTA IT Services has a Contract opening for a Healthcare Business Analyst to support a leading, Washington DC based health insurance customer. The Senior Business Analyst will have the responsibility to ensure that the business's need for changes to processes, policies and/or inf ...
-
Information Technology Business Analyst
4 weeks ago
Think Consulting Baltimore, United StatesIT Business Analyst (Remote) · Think Consulting is a transformative partner that helps clients bridge the gap between the company they are today and the company they want to become. Founded on the principles of trust and reliability, we approach every challenge with a fighting sp ...
-
sr. hris analyst
2 weeks ago
Facility SINAI CORPORATE Baltimore, United States Full timeSummary · POSITION SUMMARY: · **This is a remote position. Local candidates preferred. · The Senior HRIS Analyst acts as the Human Resources Information Systems (HRIS) primary point of contact and partners with LifeBridge Health Information Services (IS) for all HRIS related i ...
Senior Clinical Trial Coverage Analyst, Remote - Baltimore, United States - University of Maryland Medical Center Baltimore Washington
Description
Job DescriptionGeneral Summary
Under limited supervision, and with the latitude for initiative and independent judgment, performs, coordinates, and manages the creation and outsourcing of billing analysis in accordance with the Center for Medicaid and Medicare Services (CMS) regulations and the Clinical Trial Policy for all clinical trials.
This position also serves as liaison with the investigators, research teams, healthcare providers, budgeting and contracting offices at UMMS and UMB, and in coordination with departmental clinical trial management processes.
This position works with various systems including Epic and HPM Explorer for the purpose of segregating charges to ensure compliant billing for research services as well as providing pricing for budgeting purposes.
This position provides guidance and support to the Clinical Trial Analysts, and acts as a subject matter expert on coverage analysis, CMS regulations, as well as local and federal coverage determinations.
The following statements are intended to describe the general nature and level of work being performed by people assigned to this classification.
Position requirements are non-negotiable. Must know how to build Coverage Analysis for clinical trials.
This position is 100% remote and does not require any travel
The University of Maryland Medical System (UMMS) serves more than one million patients and families every year. More than 29,000 employees and 4,600 providers work at UMMS.
Each and every one of these individuals - from the patients we care for, the family members we reassure to our colleagues that we champion - represent the amazingly vibrant communities we serve.
And we continue to seek out qualified candidates who reflect the values, backgrounds and stories of our neighbors and patients.
We want to hear your voice, learn from your experiences, and be shaped by your insight as part of our workforce.
After all, when we come together from different walks of life, we become stronger, better, and more empathetic.Qualifications
Education and Experience
&v=024){kind=logo}
