Clinical Research Coverage Analyst

Saint Louis University; St. Louis (MO); On-site; USD 50,000 - 70,000; Full time

Job summary

Saint Louis University in St. Louis is seeking a Clinical Research Coverage Analyst to educate the clinical research community about studies and ensure compliance with billing practices. The role includes analyzing clinical trial protocols, developing coverage analyses, and providing training sessions.

The ideal candidate has an Associate's degree, a minimum of five years in related work, and strong knowledge of clinical research regulations. This position is full-time with a weekly schedule of 40 hours.

Qualifications

• 5+ years of related work experience.
• Ability to read and comprehend complex materials.
• Detail-oriented with skills for independent research.

Responsibilities

• Review clinical trial protocols for qualification status.
• Create Coverage Analyses using trial documents.
• Provide education and training to the clinical research community.

Skills

Knowledge of regulations and guidelines related to clinical research

Working knowledge of clinical research processes

Excellent verbal and written communication skills

Organizational and analytical skills

Education

Associate's degree

Bachelor's degree (preferred)

Job description

Job Summary

The Clinical Research Coverage Analyst provides education and training to the clinical research community of the School of Medicine regarding clinical research studies and contributes to compliant research billing practices by determining qualifying clinical trial status and performing detailed coverage analysis. The role promotes accurate billing practices in compliance with Medicare and third‑party payment rules, assists in streamlining study activation, and ensures compliance with federal, state, and university regulations.

Primary Responsibilities

• Review clinical trial protocols to determine if each new study is a qualified clinical trial pursuant to CMS policy.
• Create detailed Coverage Analyses using clinical trial documents to designate routine care procedures and billable items to patient insurance versus sponsor billing.
• Serve as the National and Local Coverage Determination (NCD and LCD) subject matter expert and interface with study teams, sponsors, and principal investigators to resolve discrepancies.
• Perform document reviews for alignment for each study and act as liaison with partnering hospitals to ensure new studies are built in the electronic medical record system.
• Submit build forms, maintain spreadsheets of builds, and request updates or corrections.
• Provide education for clinical research within the university community and conduct training sessions.
• Develop tools, standardized policies, and a training program for university clinical research coordinators.
• Assist with the management of the clinical trials organization, attend meetings, and perform other assigned duties.

Knowledge, Skills, and Abilities

• Knowledge of regulations and guidelines related to clinical research.
• Working knowledge of clinical research and multiple medical conditions.
• Working knowledge of Medicare/Medical billing processes.
• Organizational, analytical, and decision‑making skills.
• Excellent verbal and written communication skills.
• Detail‑oriented with the ability to independently research source materials and develop reasonable approaches to issues.
• Ability to read and comprehend complex materials.
• Ability to speak to groups, conduct educational sessions, and adapt teaching styles to learners.
• Ability to operate computers and various software.
• Ability to maintain confidentiality.

Minimum Qualifications

• Associate’s degree.
• Five years of related work experience.

Preferred Qualifications

• Bachelor’s degree.
• Three years of related work experience.
• Previous experience completing Medicare Coverage Analysis.
• Experience with research activity in an academic medical center.
• CPT coding experience.
• Function: Clinical Research.

Schedule

Weekly hours: 40; scheduled weekly. Function: Clinical Research.

Equal Opportunity Employer

Saint Louis University is an equal opportunity/affirmative action employer. All qualified candidates will receive consideration for the position applied for without regard to race, color, religion, sex, age, national origin, disability, marital status, sexual orientation, military/veteran status, gender identity, or other non‑merit factors.