Sr. Medicare Coverage Analyst

Location: Boston, Massachusetts, United States; 100% remote

Salary: $77,500–$90,400 per year

Company

hirify.global conducts cancer research, provides patient care, educates medical researchers, and advances public health programs.

What you will do

• Review clinical research protocols, informed consent forms, clinical trial agreements, and related study documents.
• Create coverage analysis grids and billing guides for complex clinical research protocols.
• Determine whether studies qualify under the Medicare Clinical Trial Policy and designate services billable to insurance or study sponsors.
• Act as a subject matter expert on Medicare National and Local Coverage Determinations and communicate policy updates.
• Prioritize coverage-analysis workflows and urgent protocol amendments while coordinating timelines with study teams and external stakeholders.
• Resolve protocol assessment discrepancies with sponsors and advise study teams and principal investigators before submission.

Requirements

• Bachelor’s degree or RN credential.
• At least five years of Medicare coverage analysis experience.
• Experience with research activities in an academic medical center.
• Knowledge of billing compliance, Medicare regulations, applicable laws, and institutional procedures.
• Knowledge of clinical research budgeting, the clinical trial lifecycle, and clinical trial management systems.
• Ability to independently facilitate communication between study teams and sponsors.

Nice to have

• CPT and DRG coding experience.
• Experience mentoring or training junior staff.

Culture & Benefits

• Fully remote work arrangement.
• Inclusive, diverse, and equitable environment.
• Work focused on cancer research, patient care, and public health.
• Collaboration with Harvard Medical School-affiliated hospitals and other research partners.