Clinical Research Billing & Medicare Coverage Analyst

SUNY Upstate Medical University; City of Syracuse (NY); Hybrid; USD 60.000 - 90.000; Vollzeit

Zusammenfassung

SUNY Upstate Medical University in Syracuse, NY seeks a Clinical Research Billing & Medicare Coverage Analyst to ensure accurate, compliant billing for research studies. The role involves determining whether a Medicare Coverage Analysis is required and, when applicable, performing comprehensive analyses per Medicare, FDA, and institutional guidelines.

The ideal candidate will have strong analytical skills, attention to detail, and the ability to interpret complex clinical research documents

Qualifikationen

• Bachelor's degree required.
• Three years of experience in healthcare billing, clinical trial operations, medical auditing, medical coding, and/or Medicare Coverage Analysis.
• Certification in CPC, CCS, RHIT or CCA required or to be obtained within 18 months of hire.
• Experience with regulatory and institutional guidelines preferred.

Aufgaben

• Determine whether a Medicare Coverage Analysis is required for research protocols.
• Complete comprehensive MCA analyses in accordance with Medicare, regulatory, and institutional guidelines.
• Collaborate with research, billing, and compliance stakeholders to ensure accurate and compliant billing.

Kenntnisse

Analytical skills

Attention to detail

Regulatory compliance knowledge

Stakeholder collaboration

Ausbildung

Bachelor's degree

CPC/CCS/RHIT or CCA certification

Jobbeschreibung

Job Summary:

The Clinical Research Billing & Medicare Coverage Analyst plays a critical role in ensuring the accuracy, completeness, and regulatory compliance of billing activities related to clinical research studies. This position is responsible for determining whether a Medicare Coverage Analysis (MCA) is required for research protocols and, when applicable, completing comprehensive analyses in accordance with Medicare, regulatory, and institutional guidelines. The ideal candidate will possess strong analytical skills, attention to detail, and the ability to interpret complex clinical research documents while collaborating effectively with research, billing, and compliance stakeholders.

Minimum Qualifications:

• Bachelor's degree
• Three (3) years of experience in healthcare billing, clinical trial operations, medical auditing, medical coding, and/or Medicare Coverage Analysis required.
• Coding certification (CPC, CCS, RHIT) or Certified Coverage Analyst (CCA) certification. Candidates without certification will be required to obtain one of these credentials within 18 months of hire.

Preferred Qualifications:

• Bachelor's degree in Health Information Technology or a related field preferred with three (3) years of experience in Clinical Research, Medical Billing/Coding, or a Medicare Analyst role preferred.
• Knowledge of Centers for Medicare & Medicaid Services (CMS) guidelines, FDA regulations, and National and Local Coverage Determinations (NCDs/LCDs) preferred.
• Ability to read, analyze, and interpret complex clinical research protocols, informed consent documents, and study budgets.
• Strong analytical, organizational, and communication skills with the ability to manage multiple priorities in a fast-paced environment.

Work Days:

Monday - Friday, 8am - 4:30pm

Message to Applicants:

This is a hybrid position requiring both remote and onsite work throughout the week.