[Remote] Clinical Trials Medicare Coverage Analyst

Note: The job is a remote job and is open to candidates in USA. Vitalief Inc. is a consulting and professional services firm supporting clinical research sites, sponsors, and CROs. The Clinical Trials Medicare Coverage Analyst will conduct Medicare Coverage Analyses for oncology and non-oncology clinical trials, ensure compliance with CMS regulations, maintain OnCore calendar builds, and advise cross-functional stakeholders on billing decisions and risks.

Responsibilities

• Conduct Medicare Coverage Analyses (MCA) for a mixture of oncology and non-oncology clinical trial protocols identifying which procedures and services are billable to Medicare versus those considered research related
• Review clinical trial protocols, schedules of events, and informed consent forms to ensure billing compliance with CMS regulations
• Develop, maintain, and validate OnCore calendar builds for clinical trial visits, procedures, and study milestones
• Collaborate with cross-functional teams including Clinical Operations, Finance, Regulatory, and Study Teams to provide guidance and clarification on coverage decisions
• Prepare and maintain coverage analysis documentation, summary tables, and billing justification reports for both internal and external stakeholders
• Serve as a subject matter expert for Medicare coverage rules, assisting study teams in identifying potential billing risks and providing actionable recommendations
• Support internal and external audits, ensuring all coverage decisions are well-documented and compliant with federal and sponsor requirements
• Keep current with CMS updates and industry best practices, applying knowledge to optimize coverage analyses and study operations

Skills

• Bachelor's degree in Healthcare Administration, Medical Coding, Auditing, Finance, Accounting, Nursing, or a related field
• Minimum 2 years of Medicare Coverage Analysis experience supporting clinical research studies for an Academic Medical Center (AMC) or health (hospital) system
• Must have experience working on oncology clinical trial protocols
• Hands-on experience developing, maintaining, and validating OnCore calendar builds for clinical trial visits, procedures, and study milestones is preferred – but not required as training will be provided
• Strong understanding of CMS guidelines, Medicare billing compliance, and clinical trial operations
• Demonstrated ability to work independently and manage multiple protocols and deadlines simultaneously
• Exceptional attention to detail, analytical skills, and problem-solving abilities
• Strong written and verbal communication skills, with the ability to explain complex billing concepts to non-technical stakeholders
• Comfortable working in a fully remote environment, collaborating effectively with distributed teams across multiple locations
• Proficiency in document and data management tools, including Microsoft Word, Excel, PowerPoint, Adobe, Teams, and SharePoint
• Standing, sitting, walking, visual perception, talking and hearing. Lifting up to 20lbs

Benefits

• 20 PTO days
• 9 paid holidays
• Company-paid life insurance
• Short- and long-term disability
• 401(k)-retirement plan
• Robust healthcare options
• 100% remote position

Company Overview