Coverage Analyst (Remote)

ABOUT WCG: WCG's clinical solutions are built on a foundation of best-in-class clinical services companies. We deliver transformational solutions that stimulate growth, foster compliance, and maximize efficiency for those performing clinical trials. WCG is proud to serve individuals on the frontlines of science and medicine, and the organizations striving to develop new products and therapies to improve the quality of human health. It is our role to empower them to accelerate advancement, while ensuring the risks of progress never outweigh the value of human life.

WHY WE LOVE WCG: At WCG, our employees are our most valuable asset, and as with all our assets, we invest in them with an eye toward future success. We provide each eligible employee with a comprehensive set of benefits designed to protect their personal and financial health to help make the most of their future.

• Comprehensive Benefits package - Health, Dental, Vision, Life Disability, 401k with match, and flexible spending accounts
• Employee Assistance Programs and additional work/life resources
• Referral Bonuses and Tuition Reimbursement
• Paid time off including holidays, vacation, and sick time
• Volunteer Time Off to benefit the community
• Opportunities for career development with on-the-job training, certification assistance, and continuing education reimbursement

Expected hourly rate of pay range: $24.80 to $34.60

GPS level: P1

JOB SUMMARY: The Coverage Analyst is responsible for completing coverage analysis tasks with the primary goal of supporting the efficient and effective start-up process for our site clients.

ESSENTIAL DUTIES/RESPONSIBILITIES: To perform this job successfully, an individual must be able to perform each essential duty and responsibility satisfactorily. The accountabilities listed below are representative of the knowledge, skills, and/or ability required.

• Contribute to the development of clinical trial coverage analysis. Specific duties may vary depending on team assignment and business needs:
  • Read and analyze clinical trial protocols and develop activity grid to identify required tests, procedures, and assessments.
  • Interpret Medicare policies, clinical practice guidelines, and other related documents to make billing determinations related to the clinical trials.
  • Use software and other internal resources to identify potential CPT/HCPCS codes for applicable items in the activity grid.
  • Review work completed by others as part of the internal quality review process.
• Other duties as assigned by supervisor. These may, on occasion, be unrelated to the position described here.
• Attendance and punctuality are essential functions of the position.

EDUCATION REQUIREMENTS: Bachelor's degree in related field. Significant work experience in the specific field may be considered in lieu of a relevant degree.

QUALIFICATIONS/EXPERIENCE:

• Ability to work in a performance-driven environment: a proactive, results-driven and goal-oriented approach.
• Demonstrated ability to learn and apply technical and scientific product-related information in a consultative manner.
• Excellent attention to detail and highly organized.
• Ability to understand clinical terms and descriptors and strong investigative skills with ability to think "outside the box".
• Excellent communication (oral/written) and interpersonal skills.
• Proficient with Excel.
• Preferred but not required:
  • Familiarity with the clinical trial start-up process
  • Experience reading an interpreting clinical trial protocols.
  • Familiarity with research billing guidelines (e.g. Medicare NCD 310.1) and/or general healthcare billing processes (coding, Medicare regulations, etc.).

TRAVEL REQUIREMENTS:

Physical and Sensory Requirements: The physical and sensory requirements described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be offered to individuals with disabilities to assist in performing the essential functions of the position. Work activities involve light to moderate physical effort (for example, sitting in one place for extended periods of time, standing, walking, bending, lifting lightweight objects, intermittent to sustained periods of keyboarding). Majority of time is spent in a seated position with frequent opportunity to move about at will. Activities require a variety of easy muscle movements. Work activities involve a frequent need to concentrate on a variety of sensory inputs for moderate to lengthy durations at a time requiring diligence and attention to interpret effectively. There will be a need to attend to single or simultaneous tasks where accuracy of details is important. The need for detailed and precise work is high.