Remote Medicare Coverage Analysis Coordinator

Actalent

United States

Remote

USD 55,000 - 62,000

Full time

3 days ago

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Benefits offered by this job

Medical, dental & vision

401(k) plan

Life Insurance

PTO

Job summary

Actalent is seeking a Coverage Analysis Program Coordinator for a fully remote role across the United States. The role focuses on auditing Medicare Coverage Analyses for clinical trials, interpreting protocols, and ensuring compliant billing per CMS guidelines.

You will collaborate with cross-functional teams to maintain accurate billing plans and documentation. Ideal candidates have a healthcare or life sciences background with experience in clinical research billing and CTMS/EMR systems, and

Qualifications

Bachelor's degree in healthcare, life sciences, finance, or related field is required or preferred.
Masters degree in healthcare, life sciences, finance, or related field is a plus.
Experience with Medicare regulations and clinical trial billing is essential.
Experience with MCA for clinical trials is preferred.

Responsibilities

Audit Medicare Coverage Analysis (MCA) for new and ongoing trials to ensure compliant billing.
Interpret trial protocols to identify billable services vs. research costs.
Apply CMS NCD 310.1 and other guidelines when assessing coverage and billing.
Collaborate with study teams to design billing plans for trials.
Develop and maintain billing grids and coverage analysis documentation.
Assist in budgeting negotiations with sponsors.
Ensure documentation reflects consistent coverage and costs.
Support audits with documentation and explanations.
Respond to inquiries related to trial billing and compliance.
Contribute to process improvements in MCA and billing controls.