Clinical Research - Financial Analyst I

About the role

The Clinical Trial Methods Center of Excellence at Wake Forest University Health Sciences is seeking a Medicare Coverage Analysis (MCA) Reviewer to join our dynamic team. This role involves analyzing complex study protocols and related documents to determine if a study qualifies as a clinical trial, developing coverage grids, and collaborating with the Principal Investigator and clinical research team to finalize the MCA.

Responsibilities

• Reviews complex study protocols, sponsor agreements, informed consent forms and related documents as needed to determine if a study is a qualifying clinical trial.
• Develops coverage (billing) grids in OnCore.
• Analyzes Medicare benefit policies, coverage determinations, and medical practice guidelines related to study-specific interventions.
• Collaborates with the Principal Investigator and the clinical research team to finalize the MCA and designate funding sources for research costs.
• Develops a comprehensive cost analysis for the clinical research study when preparing the initial study budget.
• Maintains a library of information on standards of care, National Coverage Decisions (NCDs), Local Coverage Determinations (LCDs), etc.
• Stays abreast of Medicare, sponsor and other federal policy and regulatory issues.
• Works with the Principal Investigator and the clinical research team to develop an internal budget that includes all costs applicable to the study.
• Creates visit schedule and budget in OnCore.
• Negotiates with sponsors to reach agreements appropriate to the costs of the trial (as needed).
• Reviews patient care charges associated with each clinical research study on a periodic basis.
• Works with Special Billing and Department post-award personnel to ensure that charges for all patient procedures are treated appropriately.
• Supports the study team in the financial management of clinical trials originating from federal, foundation, and industry funds by performing all accounts receivable functions.
• Generates and sends invoices to study sponsors.
• Tracks and monitors receivables from sponsors, including pass-through fees and milestone payments.
• Generates reports to project study financials.
• Reconciles payments received to OnCore and CORE Connect (Oracle Cloud institutional financial system).
• Notifies Financial Services of appropriate study account to receive payment.
• Resolves any financial issues with sponsor as needed.
• Ascertain amount paid and remaining amount due on assigned study sponsor accounts; establish payment plan with Department.
• Contact guarantors regarding past due accounts; re-evaluate existing payment plans as needed when account is delinquent.
• Follow up with Departments to ensure proper amounts are collected; independently recommend action to be taken regarding the account.
• Mail financial statements to Departments.
• Review balances on account and communicate with Departments via phone and email to explain professional and hospital billing and collection policy and procedure.
• Supports Department post-award personnel and Sponsored Programs in the review of revenue received prior to close out of the study account.
• Supports the closeout of study activities in OnCore, ClinCard and EPIC.
• Prepares analyses and reports of clinical trial financials for presentation to Clinical Research Administration Managers, Directors, study teams, Financial Services, and others as requested.
• Aids Principal Investigators with budget monitoring and prepares projections. Produces ad hoc analyses as needed.

Qualifications

• Bachelor's degree in Business, Accounting, Finance or a related field with 3 years of relevant experience in clinical research as a financial analyst or similar position.
• Minimum of 3 years of Business Office experience in a healthcare environment or Research Office experience preferred.

Skills

• Excellent oral and written communication skills.
• Strong interpersonal skills and attention to detail.
• Experience with computerized databases (e.g., Microsoft Excel), word processing (e.g., Microsoft Word), and presentation software (e.g., Microsoft PowerPoint).
• Demonstrates ability to work independently and manage competing priorities.

Benefits

Advocate Health offers a comprehensive suite of Total Rewards, including competitive compensation, generous retirement offerings, career development programs, and more. We also provide paid time off, health and welfare benefits, family benefits, educational assistance, and more.