Clinical Trial Coverage Analyst

We are so glad you are interested in joining Sutter Health!

**Organization:**

SHSO-Sutter Health System Office-Valley

**Position Overview:**

Responsible for determining if a study is a qualifying clinical trial, and performing the initial coverage analysis review by analyzing individual research protocol clinical services to assure federally compliant billing and reimbursement. Ensuring complete submission of documents required to conduct a coverage analysis and activate a study and submitting notification of participation letter to Noridian (MAC) when needed. Determining and documenting billing support for clinical items by reviewing the protocol, investigator brochures, sponsor budget, sponsor proposed contract, and consent template, the evidence of medical necessity justifications, and appropriate payers of protocol-specific services and federally required research-related claims modifications for service payment by insurance. Conducting the final...

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