Research Coverage Specialist

Sioux Falls, SD

Location: Sioux Falls, SD

General job duties, responsibilities, and expectations.
• Responsible for creation and maintenance of Medicare Coverage Analysis for all clinical research studies utilizing NCD and LCD’s to determine billable items and services
• Utilize internal budget to effectively develop, review, and negotiate clinical trial budgets with various sponsors
• Review study documents to build and complete OnCore calendars
• Review charges for patients related to clinical trials to ensure proper compliance and reimbursement


Equipment utilized in the unit/dept. (Are there specific computer programs used?)
• EPIC
• OnCore
• Microsoft Suite – Excel
• Smartsheet

Required skills, education, and minimum years of experience.
• Base knowledge of clinical research
• Experience with coverage analysis creation or hospital coding/billing
• Self starter and ability to work independently is a must
• Prefer a bachelor’s degree
• Recommend 3-5 years of prior experience in clinical research or relevant billing/coding/coverage analysis position

Shift or schedule requirements. (Will the employee ever work alone? Is call required? If so, how often? Are weekends required?)
Hourly position (non-exempt)
Ability to work 100% remotely or on site in Sioux Falls or Fargo
8am-4:30pm M-F schedule, but able to flex hours with prior approval
No call required


Are there direct reports for this position:
No


Dress Code:
• Business Casual if on site
• If remote, casual dress code is appropriate

Tell us about the unit/department specific training and orientation program.
• Clinical Research orientation manual review
• Onboarding with current team member
• 6-12 months depending on prior experience
• OnCore courses and training

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