Under the direct supervision of the Assistant Director of Pre-Award, the Coverage Analyst is responsible for supporting and reviewing comprehensive Medicare Coverage Analyses (MCAs) for clinical research studies to ensure compliance with federal regulations, payer requirements, and institutional billing standards. As a Coverage Analyst 1, you will collaborate with investigators, study teams, research administration, revenue cycle, and compliance stakeholders to ensure accurate set-up and maintenance of the study operations, research billing and financial compliance components. Responsible for performing job duties in accordance with mission, vision and values of University of South Florida. • Support and Review Medicare Coverage Analyses (MCAs) for industry-sponsored, investigator-initiated, and federally funded clinical research studies. • Apply Medicare National Coverage Determinations (NCDs), Local Coverage Determinations (LCDs), CMS regulations, and institutional policies to protocol and site-specific procedures and activities to document coverage determinations and rationale supporting research billing decisions. • Identify services that qualify for Medicare reimbursement and services that must be sponsor-funded. • Collaborate with internal and external stakeholders to align MCA findings with study budgets. • Identify and communicate financial risks to key stakeholders. • Identify opportunities to improve efficiency, quality, and consistency in coverage analysis processes. • Support development and maintenance of internal research budgets. • Performs other duties and projects as assigned by Assistant Director. Minimum Qualifications: Bachelor's degree in related field. Preferred Qualifications: One year of clinical research or research administration experience. Additional Information for Applicants: This position is Grant-Funded This position is not eligible for Visa Sponsorship Degree Equivalency Clause: Four years of direct experience for a bachelor’s degree. • Senate Bill 1310- The Florida Senate (https://www.flsenate.gov/Session/Bill/2023/1310) is conditional upon meeting all employment eligibility requirements in the U.S. • SB 1310: Substitution of Work Experience for Postsecondary Education Requirements • A public employer may include a postsecondary degree as a baseline requirement only as an alternative to the number of years of direct experience required, not to exceed: • (a) Two years of direct experience for an associate degree; • (b) Four years of direct experience for a bachelor’s degree; • (c) Six years of direct experience for a master’s degree; • (d) Seven years of direct experience for a professional degree; or • (e) Nine years of direct experience for a doctoral degree • Related work experience may not substitute for any required licensure, certification, or registration required for the position of employment as established by the public employer and indicated in the advertised description of the position of employment. • Minimum Qualifications that require a high school diploma are exempt from SB 1310.
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