Clinical Trial Budget & Reimbursement Specialist

Sutter Health; United States; A distancia; USD 97.000 - 146.000; Jornada completa

Descripción de la vacante

Sutter Health is seeking a qualified professional to determine if a study is a qualifying clinical trial and to perform the initial coverage analysis to ensure federally compliant billing and reimbursement. The role includes reviewing protocols, budgets, and contracts to document billing support and to ensure activation of studies.

The position requires interpreting Medicare/Medicaid decisions, applying CPT/HCPCS coding, and collaborating with investigators, sponsors, and administrative staff to

Formación

• Bachelor’s degree or equivalent education/experience required.
• Minimum 5 years of recent relevant experience.
• Knowledge of clinical research concepts and regulatory compliance required.
• Knowledge of Medicare/Medicaid coverage decisions and payer rules.
• Experience with CPT/HCPCS coding and research billing processes.
• Strong communication and collaboration skills.

Responsabilidades

• Determine if a study is a qualifying clinical trial and perform initial coverage analysis.
• Ensure complete submission of documents for coverage analysis and activation of studies.
• Document billing support by reviewing protocol, budgets, sponsor contracts, and consent templates.
• Interpret Medicare/Medicaid coverage decisions and applicable payer rules for trial-related items.
• Interface with research affiliates, investigators, and sponsors regarding reimbursement.
• Implement standardized administrative and financial support for clinical trial billing compliance.

Conocimientos

Clinical research concepts

Regulatory compliance

Medicare/Medicaid coverage decisions

Medical coding (CPT/HCPCS)

Research billing

Communication skills

Analytical thinking

Team collaboration

Detail-oriented

Educación

Bachelor’s degree or equivalent

Herramientas

Microsoft Word

Excel

Outlook

Descripción del empleo

Sutter Health is seeking a qualified professional to determine if a study is a qualifying clinical trial and to perform the initial coverage analysis to ensure federally compliant billing and reimbursement. The role includes reviewing protocols, budgets, and contracts to document billing support and to ensure activation of studies.

The position requires interpreting Medicare/Medicaid decisions, applying CPT/HCPCS coding, and collaborating with investigators, sponsors, and administrative staff to