Coverage Analyst Jobs in Florida (NOW HIRING)

Location:

Hollywood, Florida

At Memorial, we are dedicated to improving the health, well-being and, most of all, quality of life for the people entrusted to our care. An unwavering commitment to our service vision is what makes the difference. It is the foundation of The Memorial Experience.

Summary:

The Senior Financial Analyst will serve as a subject matter expert in coverage analysis as well as budget analysis and negotiation with industry sponsors. Creates and maintains internal and external research billing policies, determining applicable review requirements, and facilitates timely budget approval.

Responsibilities:

Lead the development, implementation, analysis and validation of clinical trial financial systems design and operational workflows to optimize performance and productivity.

Perform detailed coverage analysis of research procedures in alignment with CMS rules and develop audit-ready study billing grids. Assist Research Specialists in determining study status under Medicare coverage rules and in identifying services as non-covered research-only, routine care, investigational items, and services along with their associated costs.

Performs comprehensive and independent analysis of clinical trial protocols and other study documents, including the research study budget, contract, informed consent, pharmacy and lab manuals, and other supporting documentation.

Analyze industry sponsor budget proposal, clinical trial protocol and manuals to develop and negotiate comprehensive study budgets and payment terms.

Review and scrub patient bills to ensure claims are being processed accordingly and routed to the correct payor.

Ensure electronic and paper study files are created, updated, stored, and maintained according to established office practices, and MHS record retention policies, from initial contact to study closeout and beyond.

Competencies:

ACCOUNTABILITY, ACCOUNTING - FINANCIAL STATEMENTS/BUDGETS, ACCOUNTING - JOURNAL ENTRIES, ACCOUNTING - VARIANCE ANALYSIS, ACCURACY, CUSTOMER SERVICE, DEVELOPS RELATIONSHIPS, EFFECTIVE COMMUNICATION, FINANCIAL ANALYSIS, RESEARCH - REPORTING, RESPONDING TO CHANGE, STANDARDS OF BEHAVIOR

Education and Certification Requirements:

Bachelors (Required)

Additional Job Information:

Complexity of Work: This role requires critical thinking skills, effective communication, decisive judgment, the ability to build and foster positive relationships, and the ability to work with minimal supervision.Required Work Experience: Three (3) years experience with coverage analysis, clinical trial budget development and negotiation, clinical research study coordination or management, health system operations, or other related research or healthcare experience.Other Information: Additional Education Info: A Bachelor s degree in finance, science, business, healthcare administration or related field experience.

Working Conditions and Physical Requirements:

•  Bending and Stooping = 0%
•  Climbing = 0%
•  Keyboard Entry = 60%
•  Kneeling = 0%
•  Lifting/Carrying Patients 35 Pounds or Greater = 0%
•  Lifting or Carrying 0 - 25 lbs Non-Patient = 60%
•  Lifting or Carrying 2501 lbs - 75 lbs Non-Patient = 0%
•  Lifting or Carrying > 75 lbs Non-Patient = 0%
•  Pushing or Pulling 0 - 25 lbs Non-Patient = 0%
•  Pushing or Pulling 26 - 75 lbs Non-Patient = 0%
•  Pushing or Pulling > 75 lbs Non-Patient = 0%
•  Reaching = 40%
•  Repetitive Movement Foot/Leg = 0%
•  Repetitive Movement Hand/Arm = 0%
•  Running = 0%
•  Sitting = 20%
•  Squatting = 0%
•  Standing = 0%
•  Walking = 0%
•  Audible Speech = 0%
•  Hearing Acuity = 0%
•  Smelling Acuity = 0%
•  Taste Discrimination = 0%
•  Depth Perception = 0%
•  Distinguish Color = 0%
•  Seeing - Far = 60%
•  Seeing - Near = 0%
•  Bio hazardous Waste = 0%
•  Biological Hazards - Respiratory = 0%
•  Biological Hazards - Skin or Ingestion = 0%
•  Blood and/or Bodily Fluids = 0%
•  Communicable Diseases and/or Pathogens = 0%
•  Asbestos = 0%
•  Cytotoxic Chemicals = 0%
•  Dust = 20%
•  Gas/Vapors/Fumes = 0%
•  Hazardous Chemicals = 0%
•  Hazardous Medication = 0%
•  Latex = 0%
•  Computer Monitor = 60%
•  Domestic Animals = 0%
•  Extreme Heat/Cold = 0%
•  Fire Risk = 0%
•  Hazardous Noise = 0%
•  Heating Devices = 0%
•  Hypoxia = 0%
•  Laser/High Intensity Lights = 0%
•  Magnetic Fields = 0%
•  Moving Mechanical Parts = 0%
•  Needles/Sharp Objects = 0%
•  Potential Electric Shock = 0%
•  Potential for Physical Assault = 0%
•  Radiation = 0%
•  Sudden Decompression During Flights = 0%
•  Unprotected Heights = 0%
•  Wet or Slippery Surfaces = 0%

Shift:

Days

Disclaimer: This job description is not intended, nor should it be construed to be an exhaustive list of all responsibilities, skills, efforts or working conditions associated with the job. It is intended to indicate the general nature and level of work performed by employees within this classification.

Wages shown on independent job boards reflect market averages, not specific to any employer. We encourage candidates to talk to their Memorial Healthcare System recruiter to discuss actual pay rates, during the hiring process.

Memorial Healthcare System is proud to be an equal opportunity employer committed to workplace diversity.

Memorial Healthcare System recruits, hires and promotes qualified candidates for employment opportunities without regard to race, color, age, religion, gender, sexual orientation, national origin, veteran status, disability, genetic information, or any factor prohibited by law.

We are proud to offer Veteran’s Preference to former military, reservists and military spouses (including widows and widowers). You must indicate your status on your application to take advantage of this program.

Employment is subject to post offer, pre-placement assessment, including drug testing.
If you need reasonable accommodation during the application process, please call 954-276-8340 (M-F, 8am-5pm) or email TalentAcquisitionCenter@mhs.net