Coverage Analysis and Financial Quality Secialist

This position is listed on behalf of a partner company, who manages all applications and next steps. Our partner is looking for a Coverage Analysis and Financial Quality Specialist based in United States. This role serves as a key quality and compliance resource supporting clinical research study activation and ongoing operations. You will review Coverage Analyses, sponsor budgets, participant compensation structures, and related financial documentation for accuracy and compliance. The position works across clinical research, finance, regulatory, technology, and operational teams to identify and mitigate financial and billing risks. You will help ensure that study requirements, payer responsibilities, budget terms, and billing determinations remain aligned throughout the study lifecycle. The role also contributes to post-activation billing compliance, quality assurance, education, and process improvement initiatives. Strong analytical judgment and attention to detail are essential when evaluating complex research documentation and resolving discrepancies. This is a fully remote opportunity with a daytime schedule and no regular driving requirement.

Serve as the primary quality reviewer for Coverage Analyses supporting clinical trial activation, assessing accuracy, consistency, billing designations, regulatory compliance, and alignment with study requirements. Compare Coverage Analyses against protocols, schedules of events, intake documentation, Medicare coverage guidance, institutional requirements, and other relevant study materials. Identify and coordinate resolution of discrepancies between Coverage Analyses, internal budgets, sponsor budgets, and supporting study documentation. Review negotiated sponsor budgets for calculations, institutional fees, pass-through costs, payment responsibilities, participant compensation, and alignment with approved Coverage Analyses. Evaluate protocol amendments and related financial impacts, ensuring changes affecting Coverage Analysis determinations, billing, compensation, or sponsor obligations are accurately incorporated and documented. Participate in study intake and activation activities by identifying financial, billing, payer responsibility, participant compensation, and operational considerations that may affect readiness. Provide consultation on protocol-driven billing requirements, financial feasibility, participant compensation structures, and payer responsibility determinations. Support clinical research billing compliance by reviewing discrepancies, investigating concerns, and providing cross-coverage for related functions when needed. Track quality findings and recurring billing issues, analyze trends, and develop recommendations for risk reduction and process improvement. Contribute to standard operating procedures, guidance materials, training resources, review tools, workgroups, workflow redesign, audits, and quality assurance initiatives. Maintain documentation of quality reviews and findings and serve as a liaison with external vendors regarding Coverage Analysis and budget-related issues. Requirements Bachelor’s degree in Clinical Research, Healthcare Administration, Finance, Business Administration, Health Informatics, or a related field; equivalent combinations of education and experience may be considered. At least 5 years of progressively responsible experience in clinical research administration, Coverage Analysis, clinical research billing compliance, research finance, budget development, financial review, or related research operations. Strongly preferred experience reviewing Coverage Analyses, sponsor budgets, research billing determinations, research finance activities, or related compliance functions. Preferred experience in clinical research operations, including roles such as research coordinator, regulatory specialist, research administrator, or similar positions. Preferred experience working within an academic medical center, healthcare system, pharmaceutical company, contract research organization, or comparable research environment. Advanced knowledge of clinical research operations, Coverage Analysis methodology, clinical research billing compliance, sponsor budget development, research finance principles, and study activation workflows. Working knowledge of Medicare coverage guidance, qualifying clinical trial requirements, participant compensation practices, clinical trial agreements, and clinical research financial operations. Demonstrated ability to analyze complex research documents, identify discrepancies, assess risks, and recommend practical solutions. Strong analytical, organizational, problem-solving, and prioritization skills, with exceptional attention to detail and accuracy. Excellent written and verbal communication skills and the ability to collaborate effectively with investigators, research teams, vendors, finance personnel, and operational stakeholders. Proficiency with clinical research technology platforms such as OnCore, Microsoft Office applications, and related reporting and data-management tools. Ability to work independently, manage multiple priorities, and contribute effectively within cross-functional teams. Benefits Fully remote position based in the United States, with the listed location associated with Massachusetts. Full-time, daytime schedule of approximately 8:00 a.m. to 4:30 p.m. Estimated annual pay range of $74,672–$123,198.40 , with actual compensation determined according to applicable factors. Opportunity to contribute to clinical research quality, financial integrity, and billing compliance across a broad study portfolio. Collaborative environment involving clinical research, finance, regulatory, technology, investigators, vendors, and operational stakeholders. No regular driving requirement. Equal opportunity workplace committed to an inclusive and respectful environment.

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