Medicare Coverage Analyst and Billing Compliance Specialist
- Job Title
- Medicare Coverage Analyst and Billing Compliance Specialist
- Job ID
- 27736604
- Work Remote
- Yes
- Location
- Remote
- Other Location
- Description
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The START Center for Cancer Research (“START”) is the world’s largest early phase site network, fully dedicated to oncology clinical research. Throughout our history, START has provided hope to cancer patients in global community practices by offering access to cutting edge trials throughout the US and Europe. Today, with over 1,300 studies completed, and with research facilities in the United States and in Spain, Portugal, and Ireland, START’s mission is to accelerate the development of new anticancer drugs that will improve the quality of life and survival for patients with cancer and lead to its eventual cure. To date, over 43 therapies conducted at START locations have obtained FDA/EMA approval. Incredibly, while Academic Medical Centers (AMCs) conduct 80% of cancer trials, such trials reach only 20% of the patient population – leaving the majority of patients who are treated in community practices and hospitals without access to a clinical trial when their care journey calls for one. START serves the many – by bringing cancer trials to physicians and their patients in community hospitals and practices when hope is needed most.
START represents the world’s largest roster of Principal Investigators (PIs) across its eight clinical trial sites. Committed to accelerating passage from trials to treatments, START delivers hope to patients, families, and physicians around the world. As an example, in San Antonio, where START was founded, START treated the first patient ever with Keytruda – the most effective cancer drug in medical history.
We are hiring a Medicare Coverage Analyst and Billing Compliance Specialist. This is a remote role.
This role will perform comprehensive and independent final compliance review (Summary Review) of all documents related to research study billing, including the research study budget, coverage analysis, protocol, contractual terms, informed consent, and other supporting documentation.
Essential Responsibilities:-
Manage and maintain a program to provide oversight, education, and ongoing support to all areas of START involved in clinical research budgeting and billing to facilitate compliance with all relevant laws, regulations, and policies.
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Maintain understanding of CMS and FDA regulations relevant to Medicare coverage analysis, as well as other regulations pertaining to conducting a clinical trial, including Federal Anti-Kickback laws, HIPAA, and other relevant regulations.
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Review and finalize study Billing Grids, ensuring proper documentation of Coverage Analysis decisions.
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Perform comprehensive and independent final compliance review to ensure harmonization of all documents related to clinical research studies, including the research study budget, protocol, contractual terms, informed consent, and other supporting documentation.
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Perform review of study budget and calendar entry in Oncore, ensuring alignment with the Coverage Analysis.
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Perform research billing reviews/audits to ensure compliance with all applicable federal, state and local regulations, laws and rules and institutional billing policies/procedures. Recommend corrective action that will address any identified deficiencies.
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Collaborate with internal stakeholders to identify training needs. Develop and maintain training plans/programs directed toward clinical research staff that will provide the training needed to ensure appropriate billing for clinical research charges.
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Assist with the development of metrics for continual assessment and transparency.
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Collaborate closely with budget and billing team, study team members, and other internal stakeholders to identify opportunities for improvements in clinical research billing practices.
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Assist with the development of policies and procedures, monitor key performance indicators, and manage routine and special projects related to clinical research budget and billing
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Assist with data QC to ensure accuracy and alignment across multiple systems (OnCore, Veeva, ARIA, etc.).
Qualifications
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Bachelor’s degree
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Medicare Coverage Analysis trained, preferably certified
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At least 2 years of relevant experience
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Excellent communication skills, analytical, accuracy and attention to detail
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Consistently ensure that information is kept private and confidential, releasing information only to appropriate individuals
The annual base salary for this role is $72,000 - $89,000. However, base pay may vary depending on multiple individualized
factors including market location, job-related knowledge, skills, and experience.
Best-in-Class Benefits and Perks
We value our employees’ time and efforts. Our commitment to your success is enhanced by a competitive compensation, depending on experience, and an extensive benefits package including:-
Comprehensive health coverage: Medical, dental, and vision insurance provided
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Robust retirement planning: 401(k) plan available with employer matching
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Financial security: Life and disability insurance for added protection
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Flexible financial options: Health savings and flexible spending accounts offered
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Well-being and work-life balance: Paid time off, flexible schedule, and remote work choices provided
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Plus, we work to maintain the best environment for our employees, where people can learn and grow with the company. We strive to provide a collaborative, creative environment where everyone feels encouraged to contribute to our processes, decisions, planning, and culture.
More about The START Center for Cancer Research
Deeply rooted in community oncology centers globally, The START Center for Cancer Research provides access to specialized preclinical and early-phase clinical trials of novel anti-cancer agents. START clinical trial sites have conducted more than a thousand early-phase clinical trials, including for 43 therapies that were approved by the FDA. START represents the world’s largest roster of Principal Investigators (PIs) across its eight clinical trial sites. Committed to accelerating passage from trials to treatments, START delivers hope to patients, families, and physicians around the world. Learn more at STARTresearch.com.
Ready to be part of a team changing the future of cancer treatment?
Join us in our mission to conquer cancer, one clinical trial at a time. Your expertise and dedication can help us bring hope and healing to patients worldwide. Please submit your application online.
We are an equal opportunity employer that welcomes and encourages diversity in the workplace. We do not discriminate on the basis of race, color, religion, marital status, age, national origin, ancestry, physical or mental disability, medical condition, pregnancy, genetic information, gender, sexual orientation, gender identity or expression, veteran status, or any other status protected under federal, state, or local law.
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