The University of Iowa
Medicare Coverage Analyst- Hybrid - Cancer Center
The University of Iowa, Iowa City, Iowa, United States, 52245
Overview
The Holden Comprehensive Cancer Center at the University of Iowa is seeking a Medicare Coverage Analyst (MCA) responsible for conducting detailed coverage analyses of clinical trial protocols, determining the allocation of costs between routine patient care and research-related services, and ensuring compliance with Medicare National Coverage Determinations (NCDs), Local Coverage Determinations (LCDs), and institutional policies. This position supports Principal Investigators, finance staff, and research teams in accurate billing, budget development, and documentation processes. The MCA will support integration of Clinical Research Process Content (CRPC) and OnCore calendar build functionality as these systems are implemented, ensuring alignment between coverage analysis, calendar schedules, and billing workflows. This position is eligible for a hybrid work arrangement of both on-campus (UI Health Care) and remote work within the state of Iowa after completing a 6-month onsite training period, with the majority of work taking place on the UI Health Care campus. Per policy, work arrangements will be reviewed annually and must comply with the remote work program and related policies and employee travel policy when working remotely. Duties
Coverage Analysis and Compliance Perform comprehensive Medicare Coverage Analyses for clinical trial protocols, identifying billable vs. non-billable services. Ensure compliance with CMS guidelines, federal regulations, and institutional billing standards. Collaborate with Clinical Research Services finance, contracting, Research Billing Compliance (RBC) in Patient Financial Services, regulatory teams to align MCAs with budgets, Clinical Trial Agreements (CTAs), and informed consent language. Maintain knowledge of evolving CMS regulations and institutional policy changes; disseminate updates to staff as appropriate. Review and update Medicare Coverage Analyses when protocol amendments, budget revisions, or informed consent changes occur to ensure ongoing compliance with CMS and institutional policies. Assist in aligning CRPC builds with MCA determinations to ensure consistent application of billing designations across systems. Consultation and Collaboration Partner with Principal Investigators, research coordinators, and finance analysts to review protocol-related services and coverage determinations. Serve as a subject matter expert for clinical trial billing compliance, answering questions from investigators, research staff, and hospital billing offices. Provide input into budget negotiations with sponsors to ensure alignment between the MCA, budget, and contract. Crosstrain on clinical trial budget development, charge segregation, and charge review processes. Support internal and external audits by providing documentation and explanations of Medicare Coverage Analyses and billing decisions. Collaborate with calendar build specialists and informatics teams to ensure MCA determinations are accurately reflected in OnCore visit calendars. Document and Systems Management Develop and maintain MCA documentation within the OnCore Clinical Trial Management System (CTMS). Track and reconcile MCA determinations with patient billing and sponsor invoicing to prevent billing errors. Prepare and present MCA-related reports for internal audits, compliance reviews, and leadership requests. Maintain and reconcile MCA documentation throughout the life of the study, incorporating amendments and ensuring alignment with current protocols, budgets, and contracts. Support integration of CRPC functionality and OnCore calendar build workflows into existing compliance processes. Training and Education Deliver training and guidance to research and finance staff on MCA methodology, Medicare coverage rules, and clinical trial billing best practices. Assist in the development of guidance documents, SOPs, and educational resources to promote billing compliance. Mentor staff on interpreting protocols and applying coverage determinations. Independently manage a portfolio of clinical trials requiring Medicare Coverage Analysis. Complete MCA reviews within expected turnaround times to support efficient study activation. Review and update MCA for protocol amendments as they arise to ensure ongoing compliance. Contribute to special projects related to billing compliance, process improvement, and clinical trial operations. Participate in pilot projects and phased rollouts of CRPC and OnCore calendar build features, providing feedback and compliance oversight. Supervision SUPERVISION RECEIVED: No Supervision exercised SUPERVISION EXERCISED: No Supervision exercised UI Health Care Core Values (WE CARE) We are committed to welcoming the community, partners, staff, and patients with teamwork guided by compassion. We strive for accountability, respect, and empowerment in delivering quality health care, education, and research. Holden Comprehensive Cancer Center is Iowa’s only NCI-designated comprehensive cancer center. The NCI designation recognizes the center’s research, education, and patient care. The mission is: Changing Medicine. Changing Lives. ® Percent of Time:
100% Work Schedule:
Monday – Friday, hours generally between 7:00 am and 5:00 pm Regular salaried position located in Iowa City, IA Fringe benefit package
including paid vacation; sick leave; health, dental, life, and disability insurance options; and retirement plan contributions Required Qualifications Bachelor’s degree in Nursing, Health Administration, Business, or related field, or an equivalent combination of education and experience. Minimum 2 years of experience in clinical research, healthcare compliance, coding/billing, or related financial management. Demonstrated knowledge of Medicare NCDs, LCDs, and clinical trial billing requirements. Strong analytical, organizational, and problem-solving skills with a high degree of attention to detail. Excellent written and verbal communication skills with the ability to interact effectively with stakeholders. Proficiency with Microsoft Office applications (Word, Excel, Outlook) and database systems. Desired Qualifications Experience conducting Medicare Coverage Analyses within a clinical trial setting. Familiarity with Clinical Trial Management Systems (e.g., OnCore) and Electronic Medical Records (e.g., EPIC). Knowledge of University of Iowa policies and procedures related to clinical trials and billing compliance. Certification in healthcare compliance, research billing, or coding (e.g., CHRC, CPC, or equivalent). Experience developing or auditing clinical trials budgets. Application Process:
In order to be considered, applicants must upload a resume and cover letter that clearly address how they meet the listed required and desired qualifications of this position. Job openings are posted for a minimum of 7 calendar days. Successful candidates will be required to self-disclose any conviction history and will be subject to a criminal background check and credential/education verification. References: Five professional references may be requested later in the recruitment process. This position is not eligible for University sponsorship for employment authorization. Additional Details Classification Title: Senior Compliance Coordinator Appointment Type: Professional and Scientific Schedule: Full-time Work Modality Options: On Campus, Hybrid within Iowa Compensation Contact Information Contact Name: Sarah Waldschmidt Contact Email: sarah-waldschmidt@uiowa.edu Equal opportunity employer
The University of Iowa is an equal opportunity employer. All qualified applicants are encouraged to apply and will receive consideration for employment free from discrimination on the basis of race, creed, color, religion, national origin, age, sex, pregnancy (including childbirth and related conditions), disability, genetic information, veteran status, service in the U.S. military, sexual orientation, or associational preferences. Persons with disabilities who need assistance or accommodations with the application or interview process may contact University Human Resources/Faculty and Staff Disability Services at (319) 335-2660 or fsds@uiowa.edu. For jobs in UI Health care, please contact UI Health care Leave & Disability Administration at 319-356-7543.
#J-18808-Ljbffr
The Holden Comprehensive Cancer Center at the University of Iowa is seeking a Medicare Coverage Analyst (MCA) responsible for conducting detailed coverage analyses of clinical trial protocols, determining the allocation of costs between routine patient care and research-related services, and ensuring compliance with Medicare National Coverage Determinations (NCDs), Local Coverage Determinations (LCDs), and institutional policies. This position supports Principal Investigators, finance staff, and research teams in accurate billing, budget development, and documentation processes. The MCA will support integration of Clinical Research Process Content (CRPC) and OnCore calendar build functionality as these systems are implemented, ensuring alignment between coverage analysis, calendar schedules, and billing workflows. This position is eligible for a hybrid work arrangement of both on-campus (UI Health Care) and remote work within the state of Iowa after completing a 6-month onsite training period, with the majority of work taking place on the UI Health Care campus. Per policy, work arrangements will be reviewed annually and must comply with the remote work program and related policies and employee travel policy when working remotely. Duties
Coverage Analysis and Compliance Perform comprehensive Medicare Coverage Analyses for clinical trial protocols, identifying billable vs. non-billable services. Ensure compliance with CMS guidelines, federal regulations, and institutional billing standards. Collaborate with Clinical Research Services finance, contracting, Research Billing Compliance (RBC) in Patient Financial Services, regulatory teams to align MCAs with budgets, Clinical Trial Agreements (CTAs), and informed consent language. Maintain knowledge of evolving CMS regulations and institutional policy changes; disseminate updates to staff as appropriate. Review and update Medicare Coverage Analyses when protocol amendments, budget revisions, or informed consent changes occur to ensure ongoing compliance with CMS and institutional policies. Assist in aligning CRPC builds with MCA determinations to ensure consistent application of billing designations across systems. Consultation and Collaboration Partner with Principal Investigators, research coordinators, and finance analysts to review protocol-related services and coverage determinations. Serve as a subject matter expert for clinical trial billing compliance, answering questions from investigators, research staff, and hospital billing offices. Provide input into budget negotiations with sponsors to ensure alignment between the MCA, budget, and contract. Crosstrain on clinical trial budget development, charge segregation, and charge review processes. Support internal and external audits by providing documentation and explanations of Medicare Coverage Analyses and billing decisions. Collaborate with calendar build specialists and informatics teams to ensure MCA determinations are accurately reflected in OnCore visit calendars. Document and Systems Management Develop and maintain MCA documentation within the OnCore Clinical Trial Management System (CTMS). Track and reconcile MCA determinations with patient billing and sponsor invoicing to prevent billing errors. Prepare and present MCA-related reports for internal audits, compliance reviews, and leadership requests. Maintain and reconcile MCA documentation throughout the life of the study, incorporating amendments and ensuring alignment with current protocols, budgets, and contracts. Support integration of CRPC functionality and OnCore calendar build workflows into existing compliance processes. Training and Education Deliver training and guidance to research and finance staff on MCA methodology, Medicare coverage rules, and clinical trial billing best practices. Assist in the development of guidance documents, SOPs, and educational resources to promote billing compliance. Mentor staff on interpreting protocols and applying coverage determinations. Independently manage a portfolio of clinical trials requiring Medicare Coverage Analysis. Complete MCA reviews within expected turnaround times to support efficient study activation. Review and update MCA for protocol amendments as they arise to ensure ongoing compliance. Contribute to special projects related to billing compliance, process improvement, and clinical trial operations. Participate in pilot projects and phased rollouts of CRPC and OnCore calendar build features, providing feedback and compliance oversight. Supervision SUPERVISION RECEIVED: No Supervision exercised SUPERVISION EXERCISED: No Supervision exercised UI Health Care Core Values (WE CARE) We are committed to welcoming the community, partners, staff, and patients with teamwork guided by compassion. We strive for accountability, respect, and empowerment in delivering quality health care, education, and research. Holden Comprehensive Cancer Center is Iowa’s only NCI-designated comprehensive cancer center. The NCI designation recognizes the center’s research, education, and patient care. The mission is: Changing Medicine. Changing Lives. ® Percent of Time:
100% Work Schedule:
Monday – Friday, hours generally between 7:00 am and 5:00 pm Regular salaried position located in Iowa City, IA Fringe benefit package
including paid vacation; sick leave; health, dental, life, and disability insurance options; and retirement plan contributions Required Qualifications Bachelor’s degree in Nursing, Health Administration, Business, or related field, or an equivalent combination of education and experience. Minimum 2 years of experience in clinical research, healthcare compliance, coding/billing, or related financial management. Demonstrated knowledge of Medicare NCDs, LCDs, and clinical trial billing requirements. Strong analytical, organizational, and problem-solving skills with a high degree of attention to detail. Excellent written and verbal communication skills with the ability to interact effectively with stakeholders. Proficiency with Microsoft Office applications (Word, Excel, Outlook) and database systems. Desired Qualifications Experience conducting Medicare Coverage Analyses within a clinical trial setting. Familiarity with Clinical Trial Management Systems (e.g., OnCore) and Electronic Medical Records (e.g., EPIC). Knowledge of University of Iowa policies and procedures related to clinical trials and billing compliance. Certification in healthcare compliance, research billing, or coding (e.g., CHRC, CPC, or equivalent). Experience developing or auditing clinical trials budgets. Application Process:
In order to be considered, applicants must upload a resume and cover letter that clearly address how they meet the listed required and desired qualifications of this position. Job openings are posted for a minimum of 7 calendar days. Successful candidates will be required to self-disclose any conviction history and will be subject to a criminal background check and credential/education verification. References: Five professional references may be requested later in the recruitment process. This position is not eligible for University sponsorship for employment authorization. Additional Details Classification Title: Senior Compliance Coordinator Appointment Type: Professional and Scientific Schedule: Full-time Work Modality Options: On Campus, Hybrid within Iowa Compensation Contact Information Contact Name: Sarah Waldschmidt Contact Email: sarah-waldschmidt@uiowa.edu Equal opportunity employer
The University of Iowa is an equal opportunity employer. All qualified applicants are encouraged to apply and will receive consideration for employment free from discrimination on the basis of race, creed, color, religion, national origin, age, sex, pregnancy (including childbirth and related conditions), disability, genetic information, veteran status, service in the U.S. military, sexual orientation, or associational preferences. Persons with disabilities who need assistance or accommodations with the application or interview process may contact University Human Resources/Faculty and Staff Disability Services at (319) 335-2660 or fsds@uiowa.edu. For jobs in UI Health care, please contact UI Health care Leave & Disability Administration at 319-356-7543.
#J-18808-Ljbffr