Penn State Job Catalog

Additional levels that exist for this job profile can be seen below.

The Medicare Coverage Analyst within the College of Medicine ensures compliance with clinical research billing requirements; is responsible for reviewing key study documents, conducts comprehensive coverage analyses, and collaborates closely with internal and external stakeholders to support accurate billing, budgeting, and study management; contributes expertise across the research lifecycle, from study activation through post-award financial oversight.

• Review study-related documents (e.g., protocols, consent forms, agreements, budgets, investigator brochures, etc.) to determine coverage requirements and assess billing implications
• Develop and manage protocol-specific studies within the Clinical Research Management System (CRMS), translating study protocols and negotiated budgets into accessible formats to support billing compliance and financial oversight
• Perform Clinical Trials Office Ancillary Reviews to determine whether research studies require CRMS submission per institutional policies
• Draft Coverage Analysis Review (CAR) memos and billing grids (BGRIDs) to guide Medicare Coverage Analysis (MCA) discussions and inform billing determinations
• Provide individualized clinical research training and project-specific guidance to faculty and research personnel across departments
• Participate in protocol budget and feasibility meetings, updating coverage analyses as study information evolves
• Serve as a subject matter expert for colleagues involved in pre-award and post-award processes, offering insight on billing compliance and coverage rules
• Collaborate with the Human Research Protection Program Office, Office of Research Affairs, Penn State Health Finance, legal counsel, clinical departments, and ancillary units to ensure alignment with regulatory and institutional billing standards
• Work with Patient Financial Services, study teams, and post-award financial analysts to troubleshoot and resolve research billing issues
• Provide study teams with follow-up information, support resources, and clarification on coverage analysis outcomes
• Liaise with external coverage analysis vendors as needed for assigned studies
• Contribute to the development of educational tools and resources for Clinical Trials Office staff, study teams, and others involved in research billing compliance
• Mentor or train colleagues and study teams on clinical research billing processes, tools, and best practices

Level:

– Advanced Professional

Base Description:

– Completes activities, tasks, and/or projects of a functional nature.

Level Summary:

– Demonstrates proficient and comprehensive knowledge of defined skill areas/applications. Applies knowledge of principles, practices, and procedures of a particular field to decision-making and problem–solving. Works under minimum supervision on varied and sometimes difficult work assignments, conferring with supervisor or subject matter experts on unusual matters. May lead others or a team in completion of complex assignments. Interprets and communicates information clearly, accurately, and persuasively. Researches and tries new approaches when solving difficult or novel problems.

Supervisory Responsibilities:

– Indirect supervisor or mentor for other full–time employees
– May serve as direct supervisor for part–time, student, and/or temporary workers, volunteers, or a full–time employee

Fiscal Responsibilities:

– May validate and pay invoices
– May monitor/track budgets and funding

Problem Solving:

– Encounters generally routine problems with progressively more complex and/or varied problems
– Typically follows recommended course of action and procedures to resolve problems
– May apply specialized knowledge and skills to resolve complex and/or varied problems, with supervisor oversight
– Researches and tries new approaches when solving problems

Independence of Action:

– Works with minimal supervision on more difficult work assignments, conferring with supervisor on unusual matters
– Follows precedents and procedures
– May set priorities and organize work within general guidelines established by supervisor

Communication and Collaboration:

– Communicates internally and externally within working unit and the University
– May communicate with external audiences for business purposes
– Promotes open communication in a manner that builds relationships among team members
– Applies appropriate strategies for managing conflict; negotiate reasonable compromises; propose and evaluate possible solutions
– Interprets and communicates information, ideas and instructions clearly, accurately and persuasively both verbally and in written materials intended for distribution

• Comp Grade – 11
• Minimum – $68,200.00
• MidPoint – $85,200.00
• Maximum – $102,300.00