[Hiring] Research Specialist, ONC - (Coverage Analyst) @UPMC

Role Description

UPMC Hillman Cancer Center is currently hiring a regular full-time Research Specialist - Coverage Analyst, ONC to help support the Oncology Clinical Research Services team located at the Hillman Cancer Center in Shadyside/Pittsburgh, PA. This role will support the Financial Compliance team working Monday through Friday daylight hours with a remote schedule.

This position is necessary to build clinical trial budgets and coverage analysis for clinical trials. The Clinical Trial Coverage Analyst is responsible for ensuring the financial compliance and proper coverage of clinical trial procedures. Responsibilities include:

• Perform detailed coverage analysis of clinical trial protocols to distinguish billable versus non-billable items and services.
• Ensure compliance with Medicare’s Clinical Trial Policy and other payer regulations related to clinical research billing.
• Apply the appropriate CDM and/or CPT codes for potentially billable items in the coverage analysis to assist in the management of claims review.
• Collaborate with clinical research teams to develop accurate study budgets based on coverage analysis findings.
• Identify and document which study costs should be covered by the study sponsor versus the payer.
• Communicate findings to clinical research coordinators, investigators, and financial teams.
• Synchronize the final coverage analysis with appropriate final study documents.
• Maintain up-to-date knowledge of healthcare billing regulations, payer policies, and clinical trial reimbursement guidelines.
• Assist with the resolution of billing discrepancies related to clinical trial services.
• Provide training to research staff on coverage analysis and compliant billing practices.

Qualifications

• Bachelor's degree in health-related field.
• 3 years of experience in clinical trials; pre-award research administration is a plus.
• Knowledge of pre-award approval lifecycle.
• Knowledge of clinical research protocol and budgeting.
• Excellent analytical skills with attention to detail.
• High emotional intelligence, writing, and excellent communication and interpersonal skills.
• Strong organizational and time management skills.
• Ability to work independently and as part of a team.
• Clinical Research Professional Certification or related certification is a plus.

Licensure, Certifications, and Clearances

• Act 34

Company Description

UPMC Hillman Cancer Center is internationally recognized for its leadership in the prevention, detection, diagnosis, and treatment of cancer and is the region's only comprehensive cancer center designated by the National Cancer Institute. As the preeminent institution in western Pennsylvania for the delivery of cancer care, the performance of basic, translational, and clinical research, and the education of the next generation of cancer researchers and physicians, UPMC Hillman Cancer Center is exceptionally well-positioned to contribute to the global effort to reduce the burden of cancer.