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Medical Coverage Analyst
Medical Coverage Analyst-March 2024
Atlanta
Mar 28, 2026
About Medical Coverage Analyst

  IMMEDIATE NEED for Research Billing Specialist to join top hospital research institute in Atlanta, GA!!

  Description:

  This position supports the research program in management post-award financial activities for research projects conducted for large community based hospital system. The primary function of the Research Billing Specialist is to review all research patient care items and services against a Medicare Coverage Analysis (MCA) and to segregate the charges by the applicable payor type. This role is based in the Central Research Department and supports multiple inpatient and outpatient practices. This role will manage research billing for oncology, cardiology, critical care and several other disease areas. This individual works closely with the Research Financial Analysts and Research Accountant.

  PRIMARY DUTIES AND RESPONSIBILITIES:

  Responsible for interpreting and applying the MCA to patient billing review.

  Responsible for working with Patient Access, the Business Office and the Accounting and Finance Department to ensure that all research charges are identified and treated appropriately.

  Track patient visits dates via the Clinical Trial Management System (CTMS) or multiple practice Electronic Medical Records.

  Identify new research patient accounts in the financial system using reports from the CTMS and add appropriate patient flag.

  Refer to study documents, such as the MCA, study protocol, informed consent form, Clinical Trial Agreement (CTA) and budget to review new research patient accounts for patient care charges associated with each clinical research project on a regular basis.

  Credit and charge accounts to create clean insurance accounts and research only charge accounts.

  Provide the hospital billing office and practice billing offices the appropriate modifiers and study information to be included on claims.

  Ensure that professional fees are adjusted the same way that technical fees are adjusted.

  Provide high quality customer service for patients enrolled on research studies by addressing questions or concerns about charges and following-up in a timely manner.

  Additional Skills & Qualifications:

  Stay abreast of Medicare policy and regulatory documents to best inform the Medicare Coverage Analysis and patient care charge process.

  Demonstrate effective professional communication.

  Facilitate and model open communication among all staff involved in the conduct of clinical research.

  Maintain confidentiality in all aspects of communication.

  Foster professional presentation of verbal and written communications.

  Stay abreast of sponsoring agency policy and regulatory documents.

  Assist administration and management with the review, development and implementation of institutional policies and procedures to assist compliance with federal, state and local laws and regulations related to clinical research.

  Other duties as assigned

  About Actalent

  Actalent is a global leader in engineering and sciences services and talent solutions. We help visionary companies advance their engineering and science initiatives through access to specialized experts who drive scale, innovation and speed to market. With a network of almost 30,000 consultants and more than 4,500 clients across the U.S., Canada, Asia and Europe, Actalent serves many of the Fortune 500.

  Diversity, Equity & Inclusion

  At Actalent, diversity and inclusion are a bridge towards the equity and success of our people. DE&I are embedded into our culture through:

  Hiring diverse talent

  Maintaining an inclusive environment through persistent self-reflection

  Building a culture of care, engagement, and recognition with clear outcomes

  Ensuring growth opportunities for our people

  The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

  If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing process due to a disability, please email [email protected] (%[email protected]) for other accommodation options.

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