Job Summary
JOB OVERVIEW
The Coverage Analyst is expected to have advanced familiarity with a clinical trial protocol and related regulatory documents for both drug and device trials in order to prepare clear documentation of who the payor will be for all medical procedures and services required in a clinical research project. Using data from Principal Investigators and study coordinators, the incumbent determines whether proposed clinical projects 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, and, when necessary, consulting with the Medicare Administrative Contractor (MAC) for this region. The incumbent will be responsible for providing instruction to Assistant Budget and Coverage Analysts in the preparation of device billing approval applications and other trial pre-award work.
The individual will perform coverage analysis of varying complexity with information provided by Principal Investigators and Departments in compliance with UCSF policies using MS Excel and OnCore, a clinical trial management system. the incumbent must be extremely comfortable working with numerous databases and electronic information, able to quickly read and comprehend large amounts of scientific, medical, and legal text, have initiative, use good judgment and tact, interact with various internal and external customers with ease, and be highly resourceful and motivated in resolving clinical project issues in order to fulfill campus objectives.
CLINICAL TRIALS BUSINESS SUPPORT CENTER (CTBSC)
The Clinical Trials Business Support Center (CTBSC) is responsible for generating clinical research billing plans and coverage analyses and ensuring consistency in the representation of all clinical award documentation including the protocol, informed consent(s), budget, contract payment terms, and UCSF databases. The office also develops clinical research budgets and negotiates payment terms with industry sponsors. The CTBSC processes new clinical awards and amendments that include unique and/or complex proposals, other awards and business contracts, initiation of industry subcontracts, policy analysis and communication, data collection and reporting using multiple electronic research administration systems, and direction to postaward analysts related to trial invoicing. The office works with clinical research supported by Federal, Private Industry, State, City/County, Non-Profit, and Non-Governmental Organization (NGO) funding sources and is a key part of the campus Operational Excellence initiative.
ABOUT UCSF
The University of California, San Francisco (UCSF) is a leading university dedicated to promoting health worldwide through advanced biomedical research, graduate-level education in the life sciences and health professions, and excellence in patient care. It is the only campus in the 10-campus UC system dedicated exclusively to the health sciences.
Required Qualifications
* BA/BS with a major in healthcare related field and three years of experience in administrative analysis or operations research; or an equivalent combination of education and experience
* Minimum of three years of experience in medical billing, clinical research financial management or clinical research administration
* Demonstrated negotiation experience
* Instructional experience with teaching adults in the workplace
* Knowledge of regulatory, financial and administrative requirements of third party billing for clinical trials
* Strong and effective communication skills, both written and verbal. Excellent interpersonal skills
* Ability to effectively collaborate with multiple departments and demonstrated ability to work in a team environment, particularly using electronic resources and communication
* Proven ability to work independently and quickly with self-motivation and good judgment. Ability to handle multiple projects and tasks simultaneously
* Advanced skills in using software applications such as Microsoft Excel, Microsoft Word, Microsoft PowerPoint, database applications, and internet search engines. Ability to learn new systems with ease
* Strong organizational and analytical skills with attention to detail
* Knowledge of UCSF fund management policies and procedures related to clinical research budgeting
* Ability to rapidly research online resources for information supporting proposals
* Ability to quickly read and comprehend large amounts of electronic text comprised of scientific, medical, and legal language
* Familiarity with Medicare benefits
* Familiarity with FDA regulations related to clinical trials
* Demonstrated excellence in reliability and attendance
Preferred Qualifications
* Knowledge of UCSF fund management policies and procedures related to clinical research budgeting
* Proficiency with OnCore
* Experience in an Academic Medical Center environment
* Education/training in medical billing and CPT coding
Equal Employment Opportunity
The University of California San Francisco is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, or protected veteran status. Further information about the University of California, San Francisco, is available at diversity.ucsf.edu. UCSF seeks candidates whose skills, and personal and professional experience, have prepared them to contribute to our commitment to diversity and excellence, and the communities we serve.
*Req Number:* 42732BR
*Job Title:* Coverage Analyst
*Job Code and Payroll Title:* 7236 ANALYST III
*Location:* TBD
*Department Name:* Clinical Trials Business Support Center (CTBSC)
*Work Days:* Monday-Friday, 8:00am to 5:00pm
*Shift:* Days
*Shift Length:* 8 Hours
*License/Certification:* n/a
*Position Type:* Full Time
*Percentage:* 100%