Coverage Analyst (Remote)

About the role

WCG delivers transformational solutions that accelerate clinical research and advance human health. We empower experts, innovators, and pathfinders on the frontlines of science and medicine to develop breakthrough therapies while ensuring the risks of progress never outweigh the value of human life. Together, we stimulate growth, maximize efficiency, and shape the future of clinical trials.

At WCG, we invest in our people because you are the driving force behind our mission. When you grow, our impact grows. When you thrive, research accelerates. We empower you to build a meaningful career while advancing the work that improves lives.

Responsibilities

• Contribute to the development of clinical trial coverage analysis by reading and analyzing clinical trial protocols and developing activity grids to identify required tests, procedures, and assessments.
• Interpret Medicare policies, clinical practice guidelines, and other related documents to make billing determinations related to clinical trials.
• Use software and other internal resources to identify potential CPT/HCPCS codes for applicable items in the activity grid.
• Review work completed by others as part of the internal quality review process.
• Perform other duties as assigned by supervisor, which may occasionally be unrelated to the position described.
• Maintain attendance and punctuality as essential functions of the position.

Requirements

• Bachelor’s degree in a related field; significant work experience in the specific field may be considered in lieu of a relevant degree.
• At least 1 year of professional experience.
• Ability to work in a performance-driven environment with a proactive, results-driven, and goal-oriented approach.
• Demonstrated ability to learn and apply technical and scientific product-related information in a consultative manner.
• Excellent attention to detail and highly organized.
• Ability to understand clinical terms and descriptors.
• Strong investigative skills with the ability to read complex technical documents, synthesize relevant information, and clearly document findings.
• Excellent communication (oral/written) and interpersonal skills.
• Proficiency with Excel.

Preferred Qualifications

• Familiarity with the clinical trial start-up process.
• Experience interpreting clinical trial protocols to assess required activity related to visit schedules and treatment plans.
• Familiarity with research insurance billing and coverage guidelines (e.g., Medicare NCD 310.1).
• Experience as a clinical research coordinator, preferably in oncology or medical device-related therapeutic areas.

Travel Requirements

0% – 5%

Physical and Sensory Requirements

The physical and sensory requirements described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be offered to individuals with disabilities to assist in performing the essential functions of the position.

Work activities involve light to moderate physical effort (for example, sitting in one place for extended periods of time, standing, walking, bending, lifting lightweight objects, intermittent to sustained periods of keyboarding). The majority of time is spent in a seated position with frequent opportunity to move about at will. Activities require a variety of easy muscle movements. Work activities involve a frequent need to concentrate on a variety of sensory inputs for moderate to lengthy durations at a time, requiring diligence and attention to interpret effectively. There is a need to attend to single or simultaneous tasks where accuracy of details is important. The need for detailed and precise work is high.

Pay

USD $23.40 – USD $36.30 / hour