Remote MCA Program Coordinator for Clinical Trials

ACTalent; Orlando (FL); Remote; USD 55,000 - 63,000; Full time

Job summary

Actalent in Orlando, FL is seeking a Coverage Analysis Program Coordinator to lead Medicare Coverage Analyses for clinical trials, ensuring compliant billing and alignment with CMS guidelines.

Responsibilities include auditing MCA, interpreting protocols to identify billable items, and collaborating with study teams to design accurate billing plans. Remote work is available; 40–45.67 USD/hr, contract role.

Qualifications

• Bachelor's degree in healthcare, life sciences, finance, or a related field.
• 4+ years of experience in clinical research billing, coverage analysis, or healthcare compliance.
• Strong knowledge of Medicare regulations and clinical trial billing practices, including CMS NCD 310.1.
• Proven experience conducting Medicare Coverage Analysis (MCA) for clinical trials.
• Ability to interpret clinical trial protocols and differentiate routine care from research-related services for billing purposes.
• Familiarity with clinical trial management systems (CTMS).
• Familiarity with electronic medical records (EMR).
• Excellent analytical skills with the ability to review complex documents and data for accuracy and compliance.
• Strong organizational skills with the ability to manage multiple trials and deadlines simultaneously.
• Effective verbal and written communication skills to collaborate with study teams, investigators, and billing departments.

Responsibilities

• Audit Medicare Coverage Analysis (MCA) for new and ongoing clinical trials to ensure accurate and compliant billing practices.
• Interpret clinical trial protocols to identify billable services and distinguish between routine patient care and research-related costs.
• Apply CMS National Coverage Determination (NCD) 310.1 and other guidelines when assessing coverage and billing.
• Collaborate with study teams, investigators, and billing departments to design and maintain accurate billing plans for clinical trials.
• Develop and maintain detailed billing grids and coverage analysis documentation that support transparent and compliant billing processes.
• Assist in the development and negotiation of clinical trial budgets with sponsors to align financial terms with coverage analyses and billing plans.
• Ensure consistency across informed consent forms, contracts, and billing plans reflecting the same coverage and cost structure.
• Support audits related to clinical trial billing and Medicare Coverage Analysis with documentation and explanations.
• Respond to compliance inquiries related to clinical trial billing, Medicare coverage, research compliance, and quality control.
• Contribute to continuous improvement of processes and quality control measures related to MCA and clinical research billing.

Skills

Medicare regulations knowledge

Clinical trial billing

Analytical skills

Communication skills

CTMS familiarity

EMR familiarity

Project coordination

Education

Bachelor's degree in healthcare, life sciences, finance, or related field

Master's degree preferred

Tools

CTMS

EMR

Job description

Actalent in Orlando, FL is seeking a Coverage Analysis Program Coordinator to lead Medicare Coverage Analyses for clinical trials, ensuring compliant billing and alignment with CMS guidelines.

Responsibilities include auditing MCA, interpreting protocols to identify billable items, and collaborating with study teams to design accurate billing plans. Remote work is available; 40–45.67 USD/hr, contract role.