Sr Payor Policy Analyst-Xifin -Remote

Employer Industry: Healthcare Diagnostics

• Opportunity for career advancement and growth within the organization
• Comprehensive benefits including Medical, Dental, Vision, Life, STD/LTD, 401(k), Paid Time Off (PTO), Flexible Time Off (FTO), and Tuition Reimbursement
• Hybrid work schedule with flexibility, including a minimum of three in-office days per week
• Engage in impactful work influencing payer policies and reimbursement strategies
• Collaborate with industry professionals and policymakers in the laboratory field

• Assist the Manager of Payer Policy and Relations with policy and alliance development activities
• Monitor payer policy updates and changes impacting revenue, including NCD and LCD
• Act as a liaison between medical directors and payer medical directors on reimbursement issues
• Develop responses and strategies on key legislative and regulatory proposals
• Communicate updates and developments through internal and external channels

• Bachelor’s degree from an accredited four-year institution and 5 years of relevant work experience (or 7 years without a degree)
• Strong experience with diagnostics billing systems and payer-directed CPT coding
• Familiarity with healthcare revenue cycle processes, including prior authorization and appeals
• Prior work experience with insurance guidelines and payer policies
• Ability to engage with state and federal agencies and commercial insurance payers

• Advanced degree (MBA, JD, M.A./M.S., CGC, RN)
• Experience in genetic counseling or related clinical settings
• Prior experience in laboratory-related legislation and laws
• Strong network with policymakers and industry stakeholders
• Familiarity with compliance issues related to laboratory services

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