Research Coverage Analyst

Job Title
Research Coverage Analyst


Requisition Number
RE47935


Working Title
Senior Clinical Trials Coverage Analyst


Department Name
40133:Clinical Research Support Office


Work Location
Lexington, KY


Grade Level
45


Salary Range
$47,278-78,000/year


Type of Position
Staff


Position Time Status
Full-Time


Required Education


BA




Click here for more information about equivalencies:
https://hr.uky.edu/employment/working-uk/equivalencies


Required Related Experience


2 yrs




Required License/Registration/Certification

None.



Physical Requirements

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



Shift

Monday – Friday; 8:00 am to 5:00 pm.



Job Summary

|
This position is eligible to be fully remote.

The University of Kentucky 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.

The CRSO is seeking qualified candidates for a Senior Research Coverage Analyst position. 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 Senior 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 maintain the CDM for coverage analysis – with an understanding of the acute care rates for both inpatient and outpatient services, including emergency room services. Obtain data and enhance the CRSO CDM with Diagnosis-related groups (DRG) and clinically similar grouping of services for outpatient services. The position cross-train on clinical trial budget development and the Epic 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/equivalenciesIEBC (Internal Employee Being Considered).



Skills / Knowledge / Abilities

Regulatory knowledge, medical terminology and clinical knowledge, strong competency in Microsoft Office products (especially Word, Excel, PowerPoint).



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
11/05/2024


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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.