Market Access Payor Analyst

🔥 0 minutes ago

🇺🇸 United States – Remote

💵 $90k - $112.5k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

🧐 Analyst

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Natera

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 2004

🧬 Biotechnology

⚕️ Healthcare Insurance

💊 Pharmaceuticals

Biotechnology • Healthcare Insurance • Pharmaceuticals

Natera is a global leader in cell-free DNA testing technology, specializing in non-invasive genetic testing and diagnostics. The company's innovative solutions focus on areas such as prenatal screening, cancer detection, and organ transplant monitoring. By using advanced bioinformatics and DNA analysis, Natera provides healthcare professionals and patients with critical information to make more informed medical decisions.

📋 Description

• Profiling, researching, and resolving reimbursement issues for assigned payors, products, or lines of business. • Performing analysis, identifying trends, presenting opportunity areas, and prioritizing initiatives for payment and performance improvement. • Formulating and developing presentations for project analysis needs from Finance, Billing, Market Access, Product Leads, and other teams as required. • Identifying functions and barriers that affect ASP and revenue including identifying trends, opportunities, and risks for all payors and products. • Comparing payor reimbursement patterns based on medical policies, contract language, authorization requirements, and patient benefits. • Researching complex benefits and insurance verification using various systems and portals internal and external. • Investigating designated payors' literature and agencies, and staying current on new indicators, such as state statutes, laws, and other requirements. • Developing strategies to improve reimbursement and reduce denials for assigned payors based on trends and analysis findings. • Creating management reports and custom dashboards & visualizations. • Conducting complex trend review, forecasting, sensitivity analysis, what-if scenarios, and other analyses.

🎯 Requirements

• Bachelor’s Degree healthcare-related field of study or equivalent experience. • Minimum of 5 years of experience in revenue cycle or claim analysis. • Project management experience preferred. • Knowledge of CPT/HCPCS, ICD-10, modifier selection, and UB revenue codes. • Proficiency with medical or claim billing systems, Microsoft Excel, reporting software, and basic procedure coding knowledge. • Experience with PowerBi and SQL is desired. • Knowledge of medical terminology and abbreviations, and health care nomenclature and systems.

🏖️ Benefits

• Comprehensive medical, dental, vision, life and disability plans for eligible employees and their dependents. • Free testing for Natera employees and their immediate families. • Fertility care benefits. • Pregnancy and baby bonding leave. • 401k benefits. • Commuter benefits. • Generous employee referral program!