Overview
This role involves providing pre-award financial analysis for clinical research studies, focusing on cost and coverage analysis, budget negotiation, and ensuring regulatory compliance. The position supports oncology clinical trials and requires strong clinical research finance experience.
Responsibilities
- Complete Cost and Coverage Analysis (CCA) for all research studies, applying clinical knowledge and government regulations to determine appropriate billing and coverage.
- Create and negotiate study budgets, integrating Medicare Coverage rules and allowances to ensure proper reimbursement and billing compliance.
- Assess financial risk and benefit ratios for studies.
- Ensure compliance with federal, state, funding source, and other regulatory requirements related to research billing and coverage.
- Access Clinical Trials Management Systems to verify appropriate billing of research-related charges.
- Serve as a liaison between finance departments, patient financial services, research directors, and reimbursement services to communicate clinical trial billing regulations.
- Conduct patient account audits to ensure compliance.
- Develop and maintain effective relationships with research staff, sponsors, physicians, facility administrators, and financial services to coordinate study approval and execution.
- Lead and participate in task forces or councils to plan and coordinate research programs and activities.
- Evaluate approximately 100 new study proposals annually with a research budget exceeding $3 million.
Requirements
- Bachelor’s degree in business, healthcare, or a related field, or equivalent education and experience.
- Three to five years of experience in clinical research charge review, billing, coverage analysis, and clinical trials budgeting and negotiations.
- Proven analytical and modeling skills.
- Proficiency with computer spreadsheets and other applications.
Preferred Qualifications
- Working knowledge of medical terminology and experience with CPT, HCPCS, and ICD10 codes related to clinical research billing.
- Experience using Clinical Trials Management Systems.
Compensation & Benefits
- Estimated pay range: $30.56 - $50.93 per hour.
- Actual pay will be based on relevant experience, education, certifications, skills, and geographic location.
Location & Schedule
- Remote, full-time, exempt position.
- 40 hours per week, Monday through Friday, 8:00 AM to 4:30 PM.