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University of Kentucky · 12 hours ago

Medicare Coverage Analyst Sr

Greater Lexington Area

Full-time

Onsite

Mid, Senior Level

$25.01/hr - $41.25/hr

4+ years exp

The University of Kentucky’s Clinical Research Support Office is seeking a dedicated and skilled Medicare Coverage Analyst Sr. This vital role supports and enables groundbreaking clinical research by performing detailed reviews of study protocols and conducting comprehensive coverage analyses according to Medicare Clinical Trial Policy.

Higher Education

Responsibilities

Perform detailed reviews of complex study protocols, budgets, informed consent forms, contracts, FDA documents, and other relevant study documents to determine qualifying status according to Medicare Clinical Trial Policy

Conduct a comprehensive coverage analysis for all applicable study protocols across the enterprise

Determine what items of service are billable after reviewing Medicare Benefits Policy, relevant National Coverage Decisions (NCDs), Local Coverage Decisions (LCDs), Code of Federal Regulations, state law, professional practice guidelines, and, when necessary, consult with the Medicare Administrative Contractor (MAC) for the region

Develop and deliver professional coverage analysis and financial calendars where the coverage analysis is not applicable, according to national patient care services billing standards

Provide guidance to study teams about proper coding and billing for procedures in the Epic system within the context of clinical research and based on the state and national standards

Follow the UK established policies for patient care services, including documentation in the medical record and documenting coverage analysis justifications

Help develop and refine processes to integrate the coverage analysis workflow with UKHC and UK related processes and teams

Perform work collaboratively with investigators, study teams, clinical research coordinators, and other research staff while serving as a resource on coverage analysis as an integral component to maintaining proper billing integrity and compliant standards

Cross-train on clinical trial budget development and charge review process

Qualification

Clinical Trial Protocol knowledgeMedical codingBillingDetailed understanding of EpicMedical terminologyCollaborationAttention to detailCompetency in Microsoft OfficeProficient in OnCore MCACalendar consolesWork independently

Required

4 yrs

None

Ability to sit for long periods of time utilizing mouse, keyboard, computer and telephone

Ability to lift, push, or pull objects up to 50 lbs

Clinical Trial Protocol knowledge, medical coding or billing, medical terminology, attention to detail, ability to work independently, collaboration, strong competency in Microsoft Office programs, detailed understanding of the Epic billing system, proficient in OnCore MCA and Calendar consoles

Preferred

It is preferred that the candidate have work experience in a clinical setting that includes research coverage analysis, clinical research budgeting, clinical research management, and/or medical coding or billing

Candidates with coding knowledge in specific disease areas including oncology, cardiology, neurology, etc. are preferred

CA certification or training in OnCore, Epic or coding is also preferred

Benefits

200 percent match on eligible retirement contributions

Competitive health, dental, and vision coverage

Tuition benefits for classes at UK

Company

University of Kentucky

Glassdoor4.0

The University of Kentucky is a public, research-extensive, land grant university dedicated to improving people's lives through excellence in teaching, research, health care, cultural enrichment, and economic development for over 150 years.

Founded in 1865

Lexington, Kentucky, USA

10001+ employees