Coverage Analyst

WCG Clinical, Inc.; Madison (WI); Remote; USD 67,051,000 - 104,014,000; Full time

Benefits offered by this job

Medical Insurance

Dental Insurance

Vision Insurance

Life Insurance

Disability Insurance

401(k) Match

FSA

Assistance Programs

Tuition Reimbursement

On-the-job Training

Continuing Education

Paid Holidays

Job summary

WCG is seeking a Coverage Analyst to support start-up processes for site clients by performing coverage analysis tasks.

You will read clinical trial protocols, identify required tests and procedures, and interpret Medicare policies to determine billing for trials. Strong Excel skills and attention to detail are essential. This remote, full-time role offers competitive pay and opportunities for growth within One WCG.

Qualifications

• Bachelor's degree required; significant work experience may be substituted for education.
• Minimum 1 year of professional experience.
• Ability to interpret clinical trial protocols and apply billing rules.
• Strong attention to detail and highly organized.
• Proficient with Excel and able to document findings clearly.

Responsibilities

• Contribute to development of clinical trial coverage analysis.
• Read protocols and develop activity grids to identify required tests and assessments.
• Interpret Medicare policies and guidelines to determine billing for trials.
• Identify CPT/HCPCS codes using internal resources.
• Review work as part of internal quality review.
• Attend and be punctual; perform other duties as assigned.

Skills

Performance-driven

1 year experience

Technical comprehension

Attention to detail

Clinical terms understanding

Investigative skills

Communication skills

Education

Bachelor's degree

Tools

Excel

Job description

About WCG

WCG delivers transformational solutions that accelerate clinical research and advance human health. We serve the experts, innovators, and pathfinders on the frontlines of science and medicine—empowering them to develop breakthrough therapies while ensuring the risks of progress never outweigh the value of human life. Together, we stimulate growth, maximize efficiency, and shape the future of clinical trials.

Why WCG

At WCG, we invest in our people because you are the driving force behind our mission. When you grow, our impact grows. When you thrive, research accelerates. We empower you to build a meaningful career while advancing the work that improves lives.

What we offer:

• Comprehensive health and financial protection – Medical, dental, vision, life and disability insurance, 401(k) with company match, and flexible spending accounts
• Resources that support your whole life – Employee assistance programs and work/life balance tools
• Investment in your growth – Referral bonuses, tuition reimbursement, on-the-job training, certification assistance, and continuing education support
• Time to recharge – Paid holidays, vacation, and sick time
• Pathways forward – Career development opportunities across One WCG

We practice transparency in everything we do, including compensation. The salary range for this position reflects our commitment to fair, competitive pay based on your qualifications, experience, skills, education, and location. Together, we'll find the right fit for your expertise and our shared mission.

Job Summary

The Coverage Analyst is responsible for completing coverage analysis tasks with the primary goal of supporting the efficient and effective start-up process for our site clients.

ESSENTIAL DUTIES/RESPONSIBILITIES:

• Contribute to the development of clinical trial coverage analysis. Specific duties may vary depending on team assignment and business needs:
• Read and analyze clinical trial protocols and develop activity grid to identify required tests, procedures, and assessments.
• Interpret Medicare polices, clinical practice guidelines, and other related documents to make billing determinations related to clinical trials.
• Use software and other internal resources to identify potential CPT/HCPCS codes for applicable items in the activity grid.
• Review work completed by others as part of the internal quality review process.
• Other duties as assigned by supervisor. These may, on occasion, be unrelated to the position described here.
• Attendance and punctuality are essential functions of the position.

EDUCATION REQUIREMENTS:

Bachelor's degree in related field. Significant work experience in the specific field may be considered in lieu of a relevant degree.

QUALIFICATIONS/EXPERIENCE:

• Ability to work in a performance-driven environment: a proactive, results-driven and goal-oriented approach.
• Requirement of at least 1 year of professional experience.
• Demonstrated ability to learn and apply technical and scientific product-related information in a consultative manner.
• Excellent attention to detail and highly organized.
• Ability to understand clinical terms and descriptors.
• Strong investigative skills with ability to read complex technical documents, synthesize relevant information, and clearly document findings.
• Excellent communication (oral/written) and interpersonal skills.
• Proficient with Excel.
• Preferred but not required:
• Familiarity with the clinical trial start-up process.
• Experience interpreting clinical trial protocols to assess required activity related to visit schedules and treatment plans.
• Familiarity with research insurance billing and coverage guidelines (e.g. Medicare NCD 310.1).
• Experience as a clinical research coordinator, preferably in oncology or medical device related therapeutic area.

TRAVEL REQUIREMENTS:

0% – 5%

5% - 10%

10% - 20%

20% - 50%

>50%

Pay Range

USD $23.40 - USD $36.30 /Hr.

EEOC Statement

WCG is proud to be an equal opportunity employer – Qualified applicants will receive consideration for employment based on merit and without regard to race, color, national origin or ancestry, religion or creed, sex, sexual orientation, gender expression, gender identity, age, marital status, family or parental status, disability, genetic information, citizenship, veteran status, or any other legally recognized basis or status protected by federal, state, or local law. WCG complies with the Vietnam Era Veterans' Readjustment Act and Section 503 of the Rehabilitation Act. We promote a "One WCG" culture where all are welcome, respected, valued, and empowered to make a difference every day to advance clinical research.

Location

US-Remote

ID

2152

Position Type

Regular Full Time

Location Type

Remote