Remote Medicare Coverage & Billing Analyst

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

Benefits offered by this job

Medical, dental & vision

401(k) Retirement Plan

Life Insurance

Short and long-term disability

Health Spending Account (HSA)

Time Off/Leave

Job summary

Actalent is seeking a Coverage Analysis, Program Coordinator to conduct detailed reviews of clinical trial protocols to determine appropriate billing of services under Medicare regulations and institutional policies. The role supports financial integrity by developing accurate coverage analyses and documenting across trial materials.

Responsibilities include auditing MCA for trials, interpreting protocols to identify billable services, applying CMS NCD 310.1, collaborating with study teams and

Qualifications

• Bachelor’s degree in healthcare, life sciences, finance or related field required.
• Minimum 4 years of clinical research billing, coverage analysis, or healthcare compliance.
• Solid knowledge of Medicare regulations and CMS guidelines (NCD 310.1).
• Experience performing Medicare Coverage Analysis for trials.
• Ability to interpret protocols and distinguish routine vs. research-related billing.
• Familiar with CTMS and EMR systems.
• Strong analytical, organizational, and communication skills.

Responsibilities

• Audit MCA for new and ongoing trials to ensure compliant billing.
• Identify billable services by interpreting trial protocols.
• Apply CMS NCD 310.1 and other guidelines in coverage assessments.
• Collaborate with study teams and billing departments on billing plans.
• Develop billing grids and documentation to support processes.

Skills

Medicare regulations knowledge

4+ years clinical research billing

Protocol interpretation

CTMS familiarity

EMR familiarity

Analytical & detail-oriented

Strong communication

Organizational skills

Education

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

Master's degree preferred

Tools

CTMS

EMR

Job description

Actalent is seeking a Coverage Analysis, Program Coordinator to conduct detailed reviews of clinical trial protocols to determine appropriate billing of services under Medicare regulations and institutional policies. The role supports financial integrity by developing accurate coverage analyses and documenting across trial materials.

Responsibilities include auditing MCA for trials, interpreting protocols to identify billable services, applying CMS NCD 310.1, collaborating with study teams and