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Vitalief Inc. recruits top talent from the research industry to support clients with the execution and planning of clinical trials with the ultimate goal of pos
Medicare Coverage Analyst
Location
United States
Posted
92 days ago
Salary
0
No structured requirement data.
Job Description
Medicare Coverage Analyst
Vitalief
We are seeking a full-time, fully benefited Vitalief employee to serve as a Medicare Coverage Analyst in a fully remote capacity, supporting a leading academic clinical research center in Chicago. The ideal candidate brings strong expertise in Medicare billing guidelines, clinical trial operations, and OnCore calendar builds, and will ensure compliance while supporting clinical trial billing operations and advising key stakeholders. Conduct Medicare Coverage Analyses (MCA) for 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.
Job Requirements
- Bachelor’s degree in Healthcare Administration, Medical Coding, Auditing, Finance, Accounting, Nursing, or a related field.
- Minimum 3 years of Medicare Coverage Analysis experience in clinical research or healthcare billing.
- Hands-on experience developing, maintaining, and validating OnCore calendar builds for clinical trial visits, procedures, and study milestones.
- 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.
- Important Note
- Vitalief partners with clients such as major medical centers and academic institutions that often requires all on-site resources such as prospective Vitalief consultants to be inoculated annually for Influenza and successfully pass a Mantoux Tuberculin Skin Test (TST) for Mycobacterium Tuberculosis.
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