Clinical Trials Coverage Analyst

About Vitalief

Vitalief is a consulting and professional services firm dedicated to partnering with clinical research sites, sponsors, and Contract Research Organizations (CROs). Our mission is to enhance trial activation, operational performance, and workforce readiness. By integrating clinical research expertise with operational and business excellence strategies, we assist organizations in streamlining processes, reducing costs, accelerating timelines, and improving patient outcomes.

The Role

We are looking for a full-time, fully benefited Vitalief employee to serve as a Clinical Trials Coverage Analyst. This position is fully remote and supports a leading academic clinical research center located in Chicago. The ideal candidate possesses strong expertise in Medicare billing guidelines, clinical trial operations, experience with Oncology protocols, and proficiency in OnCore calendar builds. In this role, you will ensure compliance while supporting clinical trial billing operations and advising key stakeholders.

Why Join Vitalief?

• Remote Work: Work from anywhere while supporting high-impact clinical trials.

• Impact: Be a key contributor to billing compliance and operational excellence.

• Collaboration: Work with experienced clinical trial teams and expand your expertise in Medicare coverage and OnCore systems.

• Career Growth: Transition seamlessly from a Vitalief employee to a permanent employee of our client organization after six months.

• Compensation: Market-competitive salary ranging from $70,000 to $85,000, depending on experience level.

Key Responsibilities

• Conduct Medicare Coverage Analyses (MCA) for a mix of oncology and non-oncology clinical trial protocols. Identify which procedures and services are billable to Medicare versus those classified as research-related.

• Review clinical trial protocols, schedules of events, and informed consent forms to ensure billing compliance with Centers for Medicare & Medicaid Services (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 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.

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

Qualifications

• Education: Bachelor’s degree in Healthcare Administration, Medical Coding, Auditing, Finance, Accounting, Nursing, or a related field.

• Experience: Minimum of 3 years of Medicare Coverage Analysis experience in clinical research or healthcare billing.

• Specialization: Must have experience working on oncology clinical trial protocols.

• Technical Skills: Hands-on experience developing, maintaining, and validating OnCore calendar builds for clinical trial visits, procedures, and study milestones is preferred. Note: Training will be provided if this experience is not present.

• Knowledge Base: Strong understanding of CMS guidelines, Medicare billing compliance, and clinical trial operations.

• Work Style: Demonstrated ability to work independently and manage multiple protocols and deadlines simultaneously.

• Analytical Skills: Exceptional attention to detail, analytical skills, and problem-solving abilities.

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

• Remote Work: Comfortable working in a fully remote environment and collaborating effectively with distributed teams across multiple locations.

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

Physical Demands

The role involves standing, sitting, walking, visual perception, talking, and hearing. Lifting up to 20lbs may be required.

Important Health Compliance Note

Vitalief partners with clients such as major medical centers and academic institutions. These partners often require all on-site resources, including prospective Vitalief consultants, to be inoculated annually for Influenza and to successfully pass a Mantoux Tuberculin Skin Test (TST) for Mycobacterium Tuberculosis.