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:

– Senior Professional

Base Description:

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

Level Summary:

– Demonstrates advanced knowledge of principles, practices, and procedures of a particular field. Works independently on moderately complex work assignments under limited oversight, reviews progress, and evaluates results. Monitors work and projects ensuring timeliness, quality, and efficiency. Identifies and mobilizes resources to achieve outcomes. Trains others and reviews progress with management. Presents ideas, concepts, and instructions in a clear and persuasive manner. Develops new techniques, concepts, and approaches and applies them to moderately complex and strategic and/or operational issues.

Supervisory Responsibilities:

– Indirect supervisor 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
– Monitors and tracks budgets and funding

Problem Solving:

– Encounters moderately complex problems
– Applies specialized knowledge and skills to resolve problems
– Understands benefits, limitations, and impact of potential solutions

Independence of Action:

– Works independently on moderately complex work assignments, reviews progress, and evaluates results
– May set priorities and organize work within general guidelines established by supervisor
– May review the work of others to verify accuracy and conformance to required procedures and special instructions

Communication and Collaboration:

– Communicates internally within working unit and the University
– Communicates with external audiences for scheduling/coordination
– May communicate with external audiences for business purposes
– Coaches others in using appropriate strategies for resolving conflict; negotiating reasonable compromises; and proposing and evaluating possible solutions
– Give candid and constructive feedback to others to influence and persuade managers and employees to accept and implement findings and recommendations

• Comp Grade – 12
• Minimum – $76,700.00
• MidPoint – $95,900.00
• Maximum – $115,100.00