Medicare Coverage Analyst Sr

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Requisition Number: RE51979 |

Working Title:

Clinical Trials Coverage Analyst Sr | Department: 40133:
Clinical Research Support Office |

Location:

Lexington, KY (Fully Remote, Monday—Friday, 8:00 am–5:00 pm) | Grade Level: 46 | Salary: $25.01–$41.25 per hour | Position Type:
Staff Full‑Time | Required

Education:

BA | Related

Experience:

4 years |

Physical Requirements:

Ability to sit for long periods, use mouse, keyboard, computer and telephone; lift, push, or pull objects up to 50 lbs.

Shape the Future of Clinical Research Administration at the University of Kentucky.

This fully‑remote position performs detailed reviews of complex study protocols, budgets, informed consent forms, contracts, FDA documents, and other relevant study documents to determine qualifying status according to Medicare Clinical Trial Policy. It conducts comprehensive coverage analysis for all applicable study protocols across the enterprise, determining billable items after reviewing Medicare Benefits Policy, relevant National Coverage Decisions (NCDs), Local Coverage Decisions (LCDs), Code of Federal Regulations, state law, professional practice guidelines, and consulting with the Medicare Administrative Contractor (MAC) for the region.

The role develops and delivers professional coverage analysis and financial calendars and provides guidance to study teams on proper coding and billing for procedures in the Epic system. It follows UK policies for patient care services, including documentation in the medical record and coverage analysis justifications. Under the supervision of the Director of Clinical Research Administration and Billing Integrity, the analyst helps develop and refine processes to integrate the coverage analysis workflow with UKHC and UK related processes and teams, works collaboratively with investigators, study teams, clinical research coordinators, and other research staff, and cross‑trains on clinical trial budget development and charge review process.

• Review study protocols, budgets, consent forms, contracts, and FDA documents to determine Medicare coverage status.
• Conduct comprehensive coverage analysis for all applicable study protocols.
• Identify billable items and develop financial calendars where coverage is not applicable.
• Provide guidance on coding and billing for procedures in Epic.
• Document coverage analysis justifications in patient care services records.
• Collaborate with investigators and study teams to integrate coverage analysis workflow.
• Cross‑train on clinical trial budget development and charge review.

• Bachelor’s degree (BA).
• Minimum of 4 years related experience.
• Clinical trial protocol knowledge.
• Experience in medical coding or billing, medical terminology.
• Attention to detail and ability to work independently.
• Collaboration and strong competency in Microsoft Office.
• Detailed understanding of the Epic billing system.
• Proficiency in OnCore, MCA, and calendar consoles.

• Experience in a clinical setting that includes research coverage analysis, clinical research budgeting, and/or medical coding or billing.
• Knowledge of coding in specific disease areas (oncology, cardiology, neurology).
• CA certification or training in OnCore, Epic, or coding.

The University of Kentucky offers a comprehensive benefits package including a 200 % match on eligible retirement contributions, competitive health, dental, and vision coverage, tuition benefits, and more. For details, visit (Use the "Apply for this Job" box below)..

January 5, 2026

The University follows both the federal and state Constitutions as well as all applicable federal and state laws on nondiscrimination. The University provides equal opportunities for qualified persons in all aspects of institutional operations and does not discriminate on the basis of race, color, national origin, ethnic origin, religion, creed, age, physical or mental disability, veteran status, uniformed service, political belief, sex, sexual orientation, gender identity, gender expression, pregnancy, marital status, genetic information or social or economic status.

Any candidate offered a position may be required to pass pre‑employment screenings as mandated by University of Kentucky Human Resources, including a national background check and/or drug screen.