Clin Trials Rsch Coverage Analyst Senior-29035

About the role

Reporting to the Director/Manager of Clinical Trials Research Revenue Cycle, this position will create coverage analyses in accordance with Medicare's Clinical Trial Policy (NCD 310.1) and assist research staff within the clinical departments with the interpretation of related guidance and their effect on research billing processes. The analyst will provide high-level professional support in the growing efforts to conduct prospective Medicare Coverage Analysis for all clinical research studies. Exemplifies the Rush mission, vision and values and acts in accordance with Rush policies and procedures.

Responsibilities

• Maintain a detailed understanding of Medicare's Clinical Trial Policy (NCD 310.1) and related guidance documents.
• Generate detailed and accurate coverage analyses with budget overlay in a timely manner.
• Review clinical trial protocols and related regulatory documents to prepare a billing plan for all medical procedures and services required in a clinical research project.
• Review clinical research protocols and determine which procedures are routine, and therefore billable to Medicare and other third-party payers based on CMS policy and National and Local Coverage Determinations, as well as professional practice guidelines.
• Extensive independent research to identify applicable practice guidelines will be required.
• Review patient informed consent forms to ensure that the document accurately informs patients which procedures will be billed to their insurance vs. those that will be covered by the study budget, in accordance