Medicare Coverage Analyst

University of Kentucky; Lexington (KY); Remote; USD 60,000 - 90,000; Full time

Job summary

The University of Kentucky is seeking a Medicare Coverage Analyst to perform detailed reviews of study documents, ensure billing compliance, and collaborate with clinical research teams. This fully remote role requires strong knowledge of Medicare policies and previous experience in clinical research. Join UK to contribute to innovative healthcare research while enjoying a competitive benefits package.

Benefits

200 percent match on eligible retirement contributions

competitive health, dental, and vision coverage

tuition benefits for classes at UK

Qualifications

• Experience in research coverage analysis, clinical research budgeting, and medical coding or billing preferred.
• Knowledge in specific disease areas preferred (oncology, cardiology, neurology).

Responsibilities

• Conduct coverage analysis for study protocols according to Medicare policies.
• Collaborate with research teams on proper coding and billing in clinical trials.
• Develop and deliver professional coverage analysis guidelines.

Skills

Clinical Trial Protocol knowledge

medical coding or billing

medical terminology

attention to detail

ability to work independently

collaboration

strong competency in Microsoft Office programs

Education

Preferred work experience in clinical research management

Job description

Click here for more information about equivalencies:

Required License/Registration/Certification

None

Physical Requirements

Ability to sit for long periods of time utilizing mouse, keyboard, computer and telephone. Ability to lift, push, or pull objects up to 50 lbs.

Shift

Monday – Friday, 8:00am to 5:00pm with occasional early or late meetings required.
Fully Remote.

Job Summary

The University of Kentucky (UK) is hiring a Medicare Coverage Analyst!

This position is eligible to be fully remote.

This position performs detailed reviews of complex study protocols, budgets, informed consent forms, contracts, FDA documents, and other relevant study documents to determine qualifying status according to Medicare Clinical Trial Policy, and conducts a comprehensive coverage analysis for all applicable study protocols across the enterprise. It determines what items of service are billable after reviewing Medicare Benefits Policy, relevant National Coverage Decisions (NCDs), Local Coverage Decisions (LCDs), Code of Federal Regulations, state law, professional practice guidelines, and, when necessary, consulting with the Medicare Administrative Contractor ( MAC ) for the region.

This role is responsible for developing and delivering professional coverage analysis and financial calendars where the coverage analysis is not applicable, according to national patient care services billing standards. The position will provide guidance to study teams about proper coding and billing for procedures in the Epic system within the context of clinical research and based on the state and national standards. The role is responsible for following the UK established policies for patient care services, including documentation in the medical record and documenting coverage analysis justifications.

Under the direct supervision of the Director of Clinical Research Administration and Billing Integrity, the Research Coverage Analyst helps develop and refine processes to integrate the coverage analysis workflow with UKHC and UK related processes and teams. The role performs its work collaboratively with investigators, study teams, clinical research coordinators, and other research staff while serving as a resource on coverage analysis as an integral component to maintaining proper billing integrity and compliant standards. This role will also cross-train on clinical trial budget development and charge review process.

The University of Kentucky uses equivalencies in determining if a potential applicant meets the minimum education and experience. Related experience can be substituted for education. Click here for more information about equivalencies: http://www.uky.edu/hr/employment/working-uk/equivalencies

The Department

The Clinical Research Support Office ( CRSO ) provides support to investigators and study teams conducting clinical research, including clinical trials. Services provided by the CRSO include maintaining a clinical trial management system ( CTMS ), conducting coverage analysis, developing study budgets, negotiating payment terms with sponsors, and regulatory services. More information can be found at: https://research.uky.edu/clinical-research-support-office .

UK is proud to offer a benefits package that helps us recruit and retain the very best faculty and staff. In addition to your take-home pay, your benefits package is a major component of your total compensation at UK. These benefits include our 200 percent match on eligible retirement contributions; competitive health, dental, and vision coverage; tuition benefits for classes at UK, and much more. To learn more about these benefits, please visit: https://hr.uky.edu/employment/our-benefits .

Skills / Knowledge / Abilities

Clinical Trial Protocol knowledge, medical coding or billing, medical terminology, attention to detail, ability to work independently, collaboration, strong competency in Microsoft Office programs

Does this position have supervisory responsibilities?

Does this position have supervisory responsibilities? No

Preferred Education/Experience

It is preferred that the candidate have work experience in a clinical setting that included research coverage analysis, clinical research budgeting, clinical research management, and medical coding or billing. Candidates with coding knowledge in specific disease areas including oncology, cardiology, neurology etc. are preferred.

Deadline to Apply

Deadline to Apply 06/18/2025

Our University Community

We value the well-being of each of our employees and are dedicated to creating a healthy place for everyone to work, learn and live. In the interest of maintaining a safe and healthy environment for our students, employees, patients and visitors the University of Kentucky is a Tobacco & Drug Free campus.


As an Equal Opportunity Employer, we strongly encourage veterans, individuals with disabilities, women, and all minorities to consider our employment opportunities.


Any candidate offered a position may be required to pass pre-employment screenings as mandated by University of Kentucky Human Resources. These screenings may include a national background check and/or drug screen.

Posting Specific Questions

Required fields are indicated with an asterisk (*).

• * Describe your experience with research coverage analysis or medical coding/billing.

  (Open Ended Question)

• * Please choose the answer that describes your amount of paid employment experience working with Epic.
  • None
  • More than 0, up through 1 year
  • More than 1 year, up through 3 years
  • More than 3 years, up through 5 years
  • More than 5 years
• * Please indicate your years of paid work experience with clinical research management and/or clinical trials.
  • None
  • More than 0, less than 1
  • More than 1, less than 3
  • More than 3, less than 5
  • More than 5 years