100% Remote Coverage Analysis Coordinator

Actalent; United States; Remote; USD 55,000 - 62,000; Full time

Benefits offered by this job

Medical, dental & vision

401(k) plan

Life Insurance

PTO

Job summary

Actalent is seeking a Coverage Analysis Program Coordinator for a fully remote role across the United States. The role focuses on auditing Medicare Coverage Analyses for clinical trials, interpreting protocols, and ensuring compliant billing per CMS guidelines.

You will collaborate with cross-functional teams to maintain accurate billing plans and documentation. Ideal candidates have a healthcare or life sciences background with experience in clinical research billing and CTMS/EMR systems, and

Qualifications

• Bachelor's degree in healthcare, life sciences, finance, or related field is required or preferred.
• Masters degree in healthcare, life sciences, finance, or related field is a plus.
• Experience with Medicare regulations and clinical trial billing is essential.
• Experience with MCA for clinical trials is preferred.

Responsibilities

• Audit Medicare Coverage Analysis (MCA) for new and ongoing trials to ensure compliant billing.
• Interpret trial protocols to identify billable services vs. research costs.
• Apply CMS NCD 310.1 and other guidelines when assessing coverage and billing.
• Collaborate with study teams to design billing plans for trials.
• Develop and maintain billing grids and coverage analysis documentation.
• Assist in budgeting negotiations with sponsors.
• Ensure documentation reflects consistent coverage and costs.
• Support audits with documentation and explanations.
• Respond to inquiries related to trial billing and compliance.
• Contribute to process improvements in MCA and billing controls.

Skills

Medicare regulations

Clinical research billing

CTMS familiarity

EMR familiarity

Analytical skills

Organizational skills

Verbal & written communication

Education

Bachelor's degree in healthcare, life sciences, finance, or related field

Master's degree preferred

Tools

CTMS

EMR

Job description

Job Title: Coverage Analysis, Program Coordinator

Job Description

The Program Coordinator conducts detailed reviews of clinical trial protocols to determine appropriate billing of services in compliance with Medicare regulations and institutional policies. This role ensures that billing practices align with federal guidelines and supports the financial integrity of clinical research operations by developing accurate coverage analyses, collaborating with cross-functional teams, and maintaining consistent documentation across trial materials.

Responsibilities

• Audit Medicare Coverage Analysis (MCA) for new and ongoing clinical trials to ensure accurate and compliant billing practices.
• Interpret clinical trial protocols to identify billable services and distinguish clearly between routine patient care and research-related costs.
• Apply CMS National Coverage Determination (NCD) 310.1 and other relevant federal and institutional guidelines when assessing coverage and billing.
• Collaborate with study teams, investigators, and billing departments to design and maintain accurate billing plans for clinical trials.
• Develop and maintain detailed billing grids and coverage analysis documentation that support transparent and compliant billing processes.
• Assist in the development and negotiation of clinical trial budgets with sponsors to align financial terms with coverage analyses and billing plans.
• Ensure consistency across informed consent forms, contracts, and billing plans so that all documentation reflects the same coverage and cost structure.
• Support internal and external audits related to clinical trial billing and Medicare Coverage Analysis by providing accurate documentation and explanations.
• Respond to compliance inquiries related to clinical trial billing, Medicare coverage, research compliance, and quality control.
• Contribute to continuous improvement of processes and quality control measures related to Medicare Coverage Analysis and clinical research billing.

Essential Skills

• Bachelors degree in healthcare, life sciences, finance, or a related field; Masters degree preferred.
• At least 4 years of experience in clinical research billing, coverage analysis, or healthcare compliance.
• Strong knowledge of Medicare regulations and clinical trial billing practices, including application of CMS NCD 310.1.
• Proven experience conducting Medicare Coverage Analysis (MCA) for clinical trials.
• Ability to interpret clinical trial protocols and differentiate routine care from research-related services for billing purposes.
• Familiarity with clinical trial management systems (CTMS).
• Familiarity with electronic medical records (EMR).
• Excellent analytical skills with the ability to review complex documents and data for accuracy and compliance.
• Strong organizational skills with the ability to manage multiple trials and deadlines simultaneously.
• Effective verbal and written communication skills to collaborate with study teams, investigators, and billing departments.

Additional Skills & Qualifications

• Masters degree in healthcare, life sciences, finance, or a related field.
• Experience supporting audits and responding to compliance inquiries related to clinical research billing and Medicare Coverage Analysis.
• Background in research compliance and quality control for clinical trials.
• Experience developing and maintaining billing grids and coverage analysis documentation.
• Experience assisting in budget development and negotiation with clinical trial sponsors.

Work Environment

This is a remote position available to candidates residing in Alabama, Alaska, Arizona, Arkansas, Colorado, Connecticut, Florida, Georgia, Illinois, Indiana, Iowa, Kansas, Louisiana, Maryland, Michigan, Minnesota, Missouri, Montana, Nebraska, New Jersey, New York, North Carolina, Ohio, Oklahoma, Pennsylvania, South Carolina, Tennessee, Texas, and Virginia. The role involves collaborating virtually with study teams, investigators, and billing departments while working within clinical trial management systems (CTMS) and electronic medical records (EMR). The position is suited to a structured, detail-oriented work style, with a focus on documentation accuracy, regulatory compliance, and cross-functional communication in a fully remote environment.

Job Type & Location

This is a Contract position based out of Orlando, FL.

Pay and Benefits

The pay range for this position is $40.00 - $45.67/hr.

Individual compensation offered for this position within this range will depend on many factors, including qualifications, skills, relevant experience, job knowledge, geographic location, internal equity, and other pertinent job-related factors.

Eligibility requirements apply to some benefits and may depend on your jobclassification and length of employment. Benefits are subject to change and may besubject to specific elections, plan, or program terms. If eligible, the benefitsavailable for this temporary role may include the following:Medical, dental & visionCritical Illness, Accident, and Hospital401(k) Retirement Plan Pre-tax and Roth post-tax contributions availableLife Insurance (Voluntary Life & AD&D for the employee and dependents)Short and long-term disabilityHealth Spending Account (HSA)Transportation benefitsEmployee Assistance ProgramTime Off/Leave (PTO, Vacation or Sick Leave)

Job Type & Location

This is a Contract position based out of Orlando, FL.

Application Deadline

This position is anticipated to close on Nov 18, 2026.

Workplace Type

This is a fully remote position.

About Actalent

Actalent is a global leader in engineering and sciences services and talent solutions. We help visionary companies advance their engineering and science initiatives through access to specialized experts who drive scale, innovation and speed to market. With a network of almost 20,000 consultants and 5,000 clients across the U.S., Canada, Asia and Europe, Actalent serves many of the Fortune 500. We are proud to be an Engineering News-Record (ENR) Top 500 Design Firm for our engineering design services and a ClearlyRated Best of Staffing® winner for both client and talent service.

The company is an equal opportunity employer and will consider all applications withoutregard to race, sex, age, color, religion, national origin, veteran status, disability,sexual orientation, gender identity, genetic information or any characteristic protectedby law.

If you would like to request a reasonable accommodation, such as the modification oradjustment of the job application process or interviewing process due to a disability,please email [e-mail] for other accommodation options.

San Francisco Fair Chance Ordinance:

Pursuant to the San Francisco Fair Chance Ordinance, for all positions located in thecity and county of San Francisco, we will consider for employment qualified applicantswith arrest and conviction records.

Massachusetts Lie Detector:

It is unlawful in Massachusetts to require or administer a lie detector test as acondition of employment or continued employment. An employer who violates this lawshall be subject to criminal penalties and civil liability.

Use of Artificial Intelligence (AI):

We may use Artificial Intelligence (AI) to support parts of our hiring process,including sourcing, screening, and evaluating candidates. AI helps assess applicationsand qualifications, but final decisions are made by our hiring team. By applying, youacknowledge and agree that your application may be reviewed using AI tools.