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Coverage Analyst
The Coverage Analyst reviews clinical research protocols, Informed Consent Forms, Clinical Trial Agreements, and other relevant study-related documents. S/he determines whether proposed clinical research studies are a qualifying clinical trial as defined by Medicare Clinical Trial Policy, and determines what is billable after reviewing Medicare Benefits Policy, relevant National Coverage Decisions (NCDs) and Local Coverage Decisions (LCDs), Code of Federal Regulations (CFRs), state laws, professional practice guidelines, and, when necessary, consulting with the Medicare Administrative Contractor (MAC) for this region. The incumbent creates a billing justification plan to reflect which medical procedures may be billed to patient insurance and which should be billed to the study sponsor. The


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