Coverage Analyst (Remote)

WiTH Collective; Cary (NC); Hybrid; USD 80,000 - 100,000; Full time

Job summary

A leading clinical solutions provider is seeking a Coverage Analyst to conduct essential coverage analysis for clinical trial startups. This role involves evaluating clinical protocols, interpreting Medicare policies, and ensuring accurate billing practices. Candidates should hold a degree in a related field with proven analytical skills and attention to detail, along with excellent communication capabilities.

Benefits

Comprehensive Benefits package

Employee Assistance Programs

Referral Bonuses

Tuition Reimbursement

Paid time off including holidays

Qualifications

• 1 year of professional experience required.
• Ability to read and interpret clinical documents.
• Strong organizational and communication skills.

Responsibilities

• Conduct coverage analysis for clinical trials including billing determinations.
• Read and analyze clinical trial protocols; develop activity grid.
• Review quality of work submitted by peers.

Skills

Attention to Detail

Investigative Skills

Communication

Organizational Skills

Technical Learning

Proficiency in Excel

Education

Bachelor’s degree in related field

Job description

ABOUT WCG: WCG’s clinical solutions are built on a foundation of best-in-class clinical services companies. We deliver transformational solutions that stimulate growth, foster compliance, and maximize efficiency for those performing clinical trials. WCG is proud to serve individuals on the frontlines of science and medicine, and the organizations striving to develop new products and therapies to improve the quality of human health. It is our role to empower them to accelerate advancement, while ensuring the risks of progress never outweigh the value of human life.

WHY WE LOVE WCG: At WCG, our employees are our most valuable asset and as with all our assets, we invest in them with an eye toward future success. We provide each eligible employee with a comprehensive set of benefits designed to protect their personal and financial health and to help them make the most of their future.

• Comprehensive Benefits package - Health, Dental, Vision, Life Disability, 401k with match, and flexible spending accounts
• Employee Assistance Programs and additional work/life resources
• Referral Bonuses and Tuition Reimbursement
• Paid time off including holidays, vacation, and sick time
• Opportunities for career development with on-the-job training, certification assistance and continuing education reimbursement

The expected hourly range for this position is between $22.90 to $35.60. This range may vary based on the candidate's qualifications, experience, skills, education, and geographic location

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: To perform this job successfully, an individual must be able to perform each essential duty and responsibility satisfactorily.The accountabilities listed below are representative of the knowledge, skills, and/or ability required.

• 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 policies, clinical practice guidelines, and other related documents to make billing determinations related to the 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:

☐ 5% - 10%

☐ 10% - 20%

☐ 20% - 50%

☐ >50%

Physical and Sensory Requirements: The physical and sensory requirements described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be offered to individuals with disabilities to assist in performing the essential functions of the position.Work activities involve light to moderate physical effort (for example, sitting in one place for extended periods of time, standing, walking, bending, lifting lightweight objects, intermittent to sustained periods of keyboarding). Majority of time is spent in a seated position with frequent opportunity to move about at will. Activities require a variety of easy muscle movements. Work activities involve a frequent need to concentrate on a variety of sensory inputs for moderate to lengthy durations at a time requiring diligence and attention to interpret effectively. There will be a need to attend to single or simultaneous tasks where accuracy of details is important. The need for detailed and precise work is high.

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.