Introduction

The Medicare Coverage Analyst is responsible for reviewing clinical research protocols, Informed Consent Forms, Clinical Trial Agreements, and other relevant study-related documents to create a coverage analysis/billing guide. The coverage analysis indicates which medical procedures/services maybe 'Routine Cost' and billable to patient insurance and which should be billed to the study sponsor.

The Medicare Coverage Analyst determines whether proposed clinical research studies are a qualifying clinical trial as defined by the Medicare Clinical Trial Policy (NCD 310.1) and designates medical procedures/services based on relevant regulations and determinations.

Must have CPT/ DRG coding experience and understanding of Medicare rules and regulations.

Benefits

HCA offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs include:

• Comprehensive medical coverage that covers many common services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as telemedicine services and free AirMed medical transportation.
• Additional options for dental and vision benefits, life and disability coverage, flexible spending accounts, supplemental health protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and more.
  
• Fertility and family building benefits through Progyny
  
• Free counseling services and resources for emotional, physical and financial wellbeing
  
• Family support, including adoption assistance, child and elder care resources and consumer discounts
  
• 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service)
  
• Employee Stock Purchase Plan
  
• Retirement readiness and rollover services and preferred banking partnerships
  
• Education assistance (tuition, student loan, certification support, dependent scholarships)
  
• Colleague recognition program
  
• Time Away From Work Program (paid time off, paid family leave, long- and short-term disability coverage and leaves of absence)
  

Learn more about Employee Benefits

Note: Eligibility for benefits may vary by location.

Job Summary and Qualifications

• Creates coverage analysis grids.
• Researches and applies policies, guidance and guidelines from various sources including federal and state regulations.
• Understands and/or researches which services are considered routine care in our clinical research settings.
• Disseminate the coverage analysis to all appropriate parties – budgets team, sites, and operations.
• Effectively communicate results to departmental contact to ensure consensus regarding research patient care costs vs. routine care.
• Bachelor’s Degree.
• Certification in Health Research Compliance preferred.
• Experience with institutional research activity billing compliance with all applicable federal, state, and local laws, rules, regulations and policies and institutional policies and standard operating procedures.
• Knowledge of clinical research budgeting.
• Knowledge of clinical research protocol management.

Physician Services Group is skilled in physician employment, practice and urgent care operations. We are experts in hospitalist integration, and graduate medical education. We lead more than 1,300 physician practices and 170+ urgent care centers. We are HCA Healthcare’s graduate medical education leader. We provide direction for over 260 exceptional resident and fellowship programs. We focus on carrying out value-added solutions. These solutions help physicians deliver patient-centered healthcare. We support HCA Healthcare's commitment to the care and improvement of human life.

HCA Healthcare has been recognized as one of the World’s Most Ethical Companies® by the Ethisphere Institute more than ten times. In recent years, HCA Healthcare spent an estimated $3.7 billion in cost for the delivery of charitable care, uninsured discounts, and other uncompensated expenses.

"Bricks and mortar do not make a hospital. People do."- Dr. Thomas Frist, Sr.
HCA Healthcare Co-Founder

If you are looking for an opportunity that provides satisfaction and personal growth, we encourage you to apply for our Clinical Trials Coverage Analyst opening. We promptly review all applications. Highly qualified candidates will be contacted for interviews. Unlock the possibilities and apply today!

We are an equal opportunity employer and value diversity at our company. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.