Job Title: Coverage Analysis, Program Coordinator
Job Description
The Program Coordinator conducts detailed reviews of clinical trial protocols to determine appropriate billing of services in compliance with Medicare regulations and institutional policies. This role ensures that billing practices align with federal guidelines and supports the financial integrity of clinical research operations by developing accurate coverage analyses, collaborating with cross-functional teams, and maintaining consistent documentation across trial materials.
Responsibilities
Audit Medicare Coverage Analysis (MCA) for new and ongoing clinical trials to ensure accurate and compliant billing practices.
Interpret clinical trial protocols to identify billable services and distinguish clearly between routine patient care and research-related costs.
Apply CMS National Coverage Determination (NCD) 310.1 and other relevant federal and institutional guidelines when assessing coverage and billing.
Collaborate with study teams, investigators, and billing departments to design and maintain accurate billing plans for clinical trials.
Develop and maintain detailed billing grids and coverage analysis documentation that support transparent and compliant billing processes.
Assist in the development and negotiation of clinical trial budgets with sponsors to align financial terms with coverage analyses and billing plans.
Ensure consistency across informed consent forms, contracts, and billing plans so that all documentation reflects the same coverage and cost structure.
Support internal and external audits related to clinical trial billing and Medicare Coverage Analysis by providing accurate documentation and explanations.
Respond to compliance inquiries related to clinical trial billing, Medicare coverage, research compliance, and quality control.
Contribute to continuous improvement of processes and quality control measures related to Medicare Coverage Analysis and clinical research billing.
Essential Skills
Bachelors degree in healthcare, life sciences, finance, or a related field; Masters degree preferred.
At least 4 years of experience in clinical research billing, coverage analysis, or healthcare compliance.
Strong knowledge of Medicare regulations and clinical trial billing practices, including application of CMS NCD 310.1.
Proven experience conducting Medicare Coverage Analysis (MCA) for clinical trials.
Ability to interpret clinical trial protocols and differentiate routine care from research-related services for billing purposes.
Familiarity with clinical trial management systems (CTMS).
Familiarity with electronic medical records (EMR).
Excellent analytical skills with the ability to review complex documents and data for accuracy and compliance.
Strong organizational skills with the ability to manage multiple trials and deadlines simultaneously.
Effective verbal and written communication skills to collaborate with study teams, investigators, and billing departments.
Additional Skills & Qualifications
Masters degree in healthcare, life sciences, finance, or a related field.
Experience supporting audits and responding to compliance inquiries related to clinical research billing and Medicare Coverage Analysis.
Background in research compliance and quality control for clinical trials.
Experience developing and maintaining billing grids and coverage analysis documentation.
Experience assisting in budget development and negotiation with clinical trial sponsors.
Work Environment
This is a remote position available to candidates residing in Alabama, Alaska, Arizona, Arkansas, Colorado, Connecticut, Florida, Georgia, Illinois, Indiana, Iowa, Kansas, Louisiana, Maryland, Michigan, Minnesota, Missouri, Montana, Nebraska, New Jersey, New York, North Carolina, Ohio, Oklahoma, Pennsylvania, South Carolina, Tennessee, Texas, and Virginia. The role involves collaborating virtually with study teams, investigators, and billing departments while working within clinical trial management systems (CTMS) and electronic medical records (EMR). The position is suited to a structured, detail-oriented work style, with a focus on documentation accuracy, regulatory compliance, and cross-functional communication in a fully remote environment.
Job Type & Location
This is a Contract position based out of Orlando, FL.
Pay and Benefits
The pay range for this position is $40.00 - $45.67/hr.
Individual compensation offered for this position within this range will depend on many factors, including qualifications, skills, relevant experience, job knowledge, geographic location, internal equity, and other pertinent job-related factors.
Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following: Medical, dental & vision Critical Illness, Accident, and Hospital 401(k) Retirement Plan Pre-tax and Roth post-tax contributions available Life Insurance (Voluntary Life & AD&D for the employee and dependents) Short and long-term disability Health Spending Account (HSA) Transportation benefits Employee Assistance Program Time Off/Leave (PTO, Vacation or Sick Leave)
Job Type & Location
This is a Contract position based out of Orlando, FL.
Application Deadline
This position is anticipated to close on Nov 18, 2026.
Workplace Type
This is a fully remote position.
About Actalent
Actalent is a global leader in engineering and sciences services and talent solutions. We help visionary companies advance their engineering and science initiatives through access to specialized experts who drive scale, innovation and speed to market. With a network of almost 20,000 consultants and 5,000 clients across the U.S., Canada, Asia and Europe, Actalent serves many of the Fortune 500. We are proud to be an Engineering News-Record (ENR) Top 500 Design Firm for our engineering design services and a ClearlyRated Best of Staffing® winner for both client and talent service.
The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.
If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing process due to a disability, please email actalentaccommodation@actalentservices.com for other accommodation options.
San Francisco Fair Chance Ordinance: Pursuant to the San Francisco Fair Chance Ordinance, for all positions located in the city and county of San Francisco, we will consider for employment qualified applicants with arrest and conviction records.
Massachusetts Lie Detector: It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.
Use of Artificial Intelligence (AI): We may use Artificial Intelligence (AI) to support parts of our hiring process, including sourcing, screening, and evaluating candidates. AI helps assess applications and qualifications, but final decisions are made by our hiring team. By applying, you acknowledge and agree that your application may be reviewed using AI tools.
