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System One Services Medical Insurance Coverage Analyst in New Haven, Connecticut

Medical Insurance Coverage AnalystNew Haven, CT

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Type:Direct-Hire

Category:Scientific & Clinical

Job ID:218739

Date Posted:04/08/2021

Title: Medical Insurance Coverage Analyst

Duration: Direct Hire

Schedule: Full Time, 37.5 Hours M-F

Please send your resume to set up a phone interview to discuss in more detail.

Responsibilities:

We have a new opening in the greater New Haven CT area! We are looking for a Medical Insurance Billing Coverage Analyst to ensure clinical research study budgets comply with federal, state and local laws, national guidance, and regulations related to clinical research budgeting and billing.

This position offers top pay and the opportunity to work with an outstanding team!

Responsibilities:

  • Perform a comprehensive Medicare Coverage Analysis in accordance with Medicare's Clinical Trial Policy (NCD 310.1) on clinical research protocols with billable services.

  • Ensure accurate determinations of research patient billing compliance to mitigate institutional risk.

  • Maintain comprehensive documentation of all Medicare Coverage Analysis grids and systems for tracking in the institutional Clinical Trials Management System, OnCore.

  • Be responsible for sign off on all Medicare Coverage Analysis grids by assisting research faculty with the interpretation of related guidance and their effect on research billing processes, as needed.

  • Maintains, utilizes and updates data collection in a system called OnCore for use in gathering and compiling information, preparing reports and analyses, as required.

  • Utilize and review study specific Medicare Qualifying determinations (MQT) as well as the billing grids in OnCore.

  • Perform comprehensive and independent review of all documents

  • Apply excellent written and verbal communication skills.

  • Maintain excellent punctuality and attendance,

    Requirements:

  • BS Degree and four years of related experience or equivalent combination of education and experience.

  • Experience working with insurance billing, especially Medicare.

  • Experience working with clinical trial patient billing.

  • Demonstrated ability working collaboratively in a medical center, health care or university environment.

  • Knowledge (e.g., IRB, HRPP, OSP, and other regulatory approvals) extremely helpful.

  • Experience in clinical research, clinical research ops, or medical billing, and/or equivalent.

  • Coverage Analysis Certification and/or confirmation of formal training. Current Procedural Coding Certification (AAPC) desired.

  • Familiarity and working knowledge of OnCore and EPIC.

  • Joule, a System One division is a leader in specialized workforce solutions and integrated services. With more than 6,000 employees and roughly 50 offices throughout the U.S. we provide scientific, clinical, engineering, energy, IT, legal and administrative staffing services. For more than 40 years, we have delivered workforce solutions and integrated services to clients nationally.

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