Sr Payer Policy Analyst- Remote

Employer Industry: Healthcare and Laboratory Services

Why consider this job opportunity:

• Salary up to $100K
• Opportunity for career advancement and growth within the organization
• Comprehensive benefits including Medical, Dental, Vision, Life, STD/LTD, 401(k), and Tuition Reimbursement
• Flexible work schedule with remote work options available
• Engage in meaningful work that contributes to healthcare breakthroughs and improves care delivery

(Job Responsibilities)

• Collaborate with management teams to understand technologies and provide insights on payer policy for Government and Commercial payers
• Attend payer meetings to communicate policy concerns and denial trends
• Monitor updates on payer policies affecting revenue and reimbursement
• Serve as a liaison between medical directors and payer medical directors regarding policy issues
• Develop and advocate for policy positions in response to regulatory proposals and legislation

• Bachelor’s degree from an accredited institution and 5 years of relevant work experience; or 7 years of work experience without a degree
• Strong experience in genetic counseling and prior authorization processes
• Familiarity with insurance guidelines and payer policy
• Previous work experience with state and federal agencies and commercial insurance payers
• Knowledge of healthcare revenue cycle processes, including coding, claims, and billing compliance

• Advanced degree (MBA, JD, M.A. / M.S., CGC, RN)
• Previous experience in a clinical or business setting related to laboratory services
• Established relationships with policymakers for Medicare Contractors and Medicaid Payers
• Prior experience in appeals and claim denial processes
• Ability to engage with third-party groups affected by regulations impacting lab services

#Healthcare #Laboratory Services #Remote Work #Career Growth #Policy Analysis

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