Coverage Analyst (Remote)

WCG delivers transformational solutions that accelerate clinical research and advance human health. We serve the experts, innovators, and pathfinders on the frontlines of science and medicine—empowering them to develop breakthrough therapies while ensuring the risks of progress never outweigh the value of human life. Together, we stimulate growth, maximize efficiency, and shape the future of clinical trials. 

At WCG, we invest in our people because you are the driving force behind our mission. When you grow, our impact grows. When you thrive, research accelerates. We empower you to build a meaningful career while advancing the work that improves lives. 

What we offer: 

• Comprehensive health and financial protection – Medical, dental, vision, life and disability insurance, 401(k) with company match, and flexible spending accounts 

• Resources that support your whole life – Employee assistance programs and work/life balance tools 

• Investment in your growth – Referral bonuses, tuition reimbursement, on-the-job training, certification assistance, and continuing education support 

• Time to recharge – Paid holidays, vacation, and sick time 

• Pathways forward – Career development opportunities across One WCG 

We practice transparency in everything we do, including compensation. The salary range for this position reflects our commitment to fair, competitive pay based on your qualifications, experience, skills, education, and location. Together, we'll find the right fit for your expertise and our shared mission. 

The Coverage Analyst is responsible for completing coverage analysis tasks with the primary goal of supporting the efficient and effective start-up process for our site clients.

ESSENTIAL DUTIES/RESPONSIBILITIES: To perform this job successfully, an individual must be able to perform each essential duty and responsibility satisfactorily.  The accountabilities listed below are representative of the knowledge, skills, and/or ability required.

• Contribute to the development of clinical trial coverage analysis. Specific duties may vary depending on team assignment and business needs:
  • Read and analyze clinical trial protocols and develop activity grid to identify required tests, procedures, and assessments.
  • Interpret Medicare polices, clinical practice guidelines, and other related documents to make billing determinations related to clinical trials. 
  • Use software and other internal resources to identify potential CPT/HCPCS codes for applicable items in the activity grid.
  • Review work completed by others as part of the internal quality review process.
• Other duties as assigned by supervisor. These may, on occasion, be unrelated to the position described here.
• Attendance and punctuality are essential functions of the position.

EDUCATION REQUIREMENTS: Bachelor’s degree in related field. Significant work experience in the specific field may be considered in lieu of a relevant degree.

QUALIFICATIONS/EXPERIENCE:

• Ability to work in a performance-driven environment: a proactive, results-driven and goal-oriented approach.
• Requirement of at least 1 year of professional experience.
• Demonstrated ability to learn and apply technical and scientific product-related information in a consultative manner.
• Excellent attention to detail and highly organized.
• Ability to understand clinical terms and descriptors.
• Strong investigative skills with ability to read complex technical documents, synthesize relevant information, and clearly document findings.
• Excellent communication (oral/written) and interpersonal skills.
• Proficient with Excel.
• Preferred but not required:
  • Familiarity with the clinical trial start-up process.
  • Experience interpreting clinical trial protocols to assess required activity related to visit schedules and treatment plans.
  • Familiarity with research insurance billing and coverage guidelines (e.g. Medicare NCD 310.1).
  • Experience as a clinical research coordinator, preferably in oncology or medical device related therapeutic area. 

TRAVEL REQUIREMENTS:   

Physical and Sensory Requirements: The physical and sensory requirements described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be offered to individuals with disabilities to assist in performing the essential functions of the position. Work activities involve light to moderate physical effort (for example, sitting in one place for extended periods of time, standing, walking, bending, lifting lightweight objects, intermittent to sustained periods of keyboarding).  Majority of time is spent in a seated position with frequent opportunity to move about at will.  Activities require a variety of easy muscle movements.  Work activities involve a frequent need to concentrate on a variety of sensory inputs for moderate to lengthy durations at a time requiring diligence and attention to interpret effectively.  There will be a need to attend to single or simultaneous tasks where accuracy of details is important.  The need for detailed and precise work is high.  

WCG is proud to be an equal opportunity employer. Qualified applicants will receive consideration for employment based on merit and without regard to race, color, national origin or ancestry, religion or creed, sex, sexual orientation, gender expression, gender identity, age, marital status, family or parental status, disability, genetic information, citizenship, veteran status, or any other legally recognized basis or status protected by federal, state, or local law. WCG complies with the Vietnam Era Veterans' Readjustment Act and Section 503 of the Rehabilitation Act. We promote a "One WCG" culture where all are welcome, respected, valued, and empowered to make a difference every day to advance clinical research.