Clinical Trials Medicare Coverage Analyst

Vitalief • New Brunswick, NJ • 3h ago

ABOUT VITALIEF

Vitalief is a consulting and professional services firm that partners with clinical research sites, sponsors, and CROs to improve trial activation, operational performance, and workforce readiness. By combining clinical research expertise with operational and business excellence, we help organizations streamline processes, reduce costs, accelerate timelines, and enhance patient outcomes.

THE ROLE

We are seeking a full-time, fully benefited Vitalief employee to serve as a Clinical Trials Medicare Coverage Analyst in a fully remote capacity, supporting Vitalief's client, a leading academic clinical research center in the Chicago area. The ideal candidate brings strong expertise in Medicare billing guidelines, clinical trial operations, experience working on Oncology protocols, and OnCore calendar builds, and will ensure compliance while supporting clinical trial billing operations and advising key stakeholders.

Why Join Vitalief?

Make an Impact: Support leading AMCs and health systems in improving clinical trial financial performance and compliance.

Innovation-Driven: Help modernize clinical trial budgeting and billing processes using technology and best practices.

People-First Culture: Thrive in an environment that fosters growth, innovation, and collaboration.

Comprehensive Benefits: Enjoy 20 PTO days, 9 paid holidays, company-paid life insurance, short- and long-term disability, a 401(k)-retirement plan, and robust healthcare options.

Flexible & Remote-Friendly: This is a 100% remote position.

Salary Range: $75,000 to $100,000 - Based on experience level.

KEY RESPONSIBILITIES

Conduct Medicare Coverage Analyses (MCA) for a mixture of oncology and non-oncology clinical trial protocols identifying which procedures and services are billable to Medicare versus those considered research related.

Review clinical trial protocols, schedules of events, and informed consent forms to ensure billing compliance with CMS regulations.

Develop, maintain, and validate OnCore calendar builds for clinical trial visits, procedures, and study milestones.

Collaborate with cross-functional teams including Clinical Operations, Finance, Regulatory, and Study Teams to provide guidance and clarification on coverage decisions.

Prepare and maintain coverage analysis documentation, summary tables, and billing justification reports for both internal and external stakeholders.

Serve as a subject matter expert for Medicare coverage rules, assisting study teams in identifying potential billing risks and providing actionable recommendations.

Support internal and external audits, ensuring all coverage decisions are well-documented and compliant with federal and sponsor requirements.

Keep current with CMS updates and industry best practices, applying knowledge to optimize coverage analyses and study operations.

QUALIFICATIONS

Bachelor's degree in Healthcare Administration, Medical Coding, Auditing, Finance, Accounting, Nursing, or a related field.

Minimum 3 years of Medicare Coverage Analysis experience supporting clinical research studies for an Academic Medical Center (AMC) or health (hospital) system.

Must have experience working on oncology clinical trial protocols.

Hands-on experience developing, maintaining, and validating OnCore calendar builds for clinical trial visits, procedures, and study milestones is preferred - but not required as training will be provided.

Strong understanding of CMS guidelines, Medicare billing compliance, and clinical trial operations.

Demonstrated ability to work independently and manage multiple protocols and deadlines simultaneously.

Exceptional attention to detail, analytical skills, and problem-solving abilities.

Strong written and verbal communication skills, with the ability to explain complex billing concepts to non-technical stakeholders.

Comfortable working in a fully remote environment, collaborating effectively with distributed teams across multiple locations.

Proficiency in document and data management tools, including Microsoft Word, Excel, PowerPoint, Adobe, Teams, and SharePoint.

PHYSICAL DEMANDS: Standing, sitting, walking, visual perception, talking and hearing. Lifting up to 20lbs.

Similar Jobs

Optometrist

America's Best • Morristown, NJ • 27min ago

Hospital & Medical

Love What You Do - And Where You Do It We're reimagining what a career in optometry should look like. Think less burnout, more balance. Less micromanagement, more autonomy. Less routine, more purpose! At our practice, yo...

27min ago

Go to Apply

Optometrist

America's Best • Hamilton, NJ • 29min ago

Hospital & Medical

Short Sundays. Full Pay. Work a shorter day, keep full pay, and still enjoy the rest of your Sunday. This flexible role is ideal for optometrists who want to supplement their schedule and income - while keeping personal...

29min ago

Go to Apply

Pharmacy Customer Service Associate

Walgreens • Freehold, NJ • 31min ago

Hospital & Medical

1871464BR Title: Pharmacy Customer Service Associate Job Description: Models and delivers a distinctive and delightful customer experience. Registers sales on assigned cash register, provides customers with courteous, fa...

31min ago

Go to Apply

Pharmacy Customer Service Associate

Walgreens • Basking Ridge, NJ • 33min ago

Hospital & Medical

1870758BR Title: Pharmacy Customer Service Associate Job Description: Models and delivers a distinctive and delightful customer experience. Registers sales on assigned cash register, provides customers with courteous, fa...

33min ago

Go to Apply

Clinical Nutrition Manager II - Healthcare

Sodexo • Belle Mead, NJ • 38min ago

Hospital & Medical

Sodexo is seeking a Registered Dietitian for a Clinical Nutrition Manager position at Carrier Clinic in Belle Mead, NJ, located in Central North Jersey. Carrier Clinic is a 297-bed behavioral health facility that include...

38min ago

Go to Apply

Health System Specialist (WRIISC)

Veterans Affairs, Veterans Health Administration • East Orange, NJ • 4h ago

Hospital & Medical

Summary EXPRT Center advances VA's mission to improve the health outcomes of Veterans with deployment and environmental related exposures through coordinated efforts in clinical and translational research, data analytics...

4h ago

Go to Apply

Registered Nurse- Nurse Manager, Hemodialysis

Veterans Affairs, Veterans Health Administration • East Orange, NJ • 4h ago

Hospital & Medical

Summary The Nurse Manager (NM) assigned to the Patient Care Service / Acute Care Unit is the designated first-line supervisory authority and is responsible and accountable for the operation of their assigned units. They...

4h ago

Go to Apply

Adjunct Nursing, Faculty-Middlesex

Hackensack Meridian Health • Perth Amboy, NJ • 1d ago

Hospital & Medical

null 184373 Minimum rate of $44.30 Hourly HMH is committed to pay equity and transparency for our team members. The posted rate of pay in this job posting is a reasonable good faith estimate of the minimum base pay for t...

1d ago

Go to Apply

Registered Nurse

BAYADA Home Health Care • Union, NJ • 1d ago

Hospital & Medical

Registered Nurse (RN) - Senior Living Visits Full-Time | Somerset, Middlesex, Monmouth & Union Counties, NJ Make an Impact as a Registered Nurse (RN) at BAYADA Home Health Care BAYADA Home Health Care is seeking a Re...

1d ago

Go to Apply

Registered Nurse

BAYADA Home Health Care • Freehold, NJ • 1d ago

Hospital & Medical

1d ago

Go to Apply

Subscribe to get new jobs sent directly to you
(no charge, cancel anytime)