Market Access Payor Analyst

1 hour, 33 minutes ago
Full-time
Senior
Data Science and Analytics
Natera

Natera

Natera specializes in cell-free DNA testing, providing advanced genetic testing services for oncology, women's health, and organ health to help families diagnose and manage genetic diseases.

Pharmaceuticals
1K-5K
Founded 2004

Description

  • Profile, research, and resolve reimbursement issues for assigned payors, products, or lines of business.
  • Formulate presentations and analysis for Finance, Billing, Market Access, Product Leads, and other stakeholders.
  • Identify factors that affect ASP and revenue, including trends, opportunities, and risks.
  • Compare payor reimbursement patterns based on medical policies, contract language, authorization requirements, and patient benefits.
  • Research complex benefits and insurance verification using internal and external systems and portals.
  • Investigate payor literature, agencies, statutes, laws, and other reimbursement-related requirements.
  • Develop strategies to improve reimbursement and reduce denials based on trend analysis.
  • Identify opportunities for process improvement, automation, and efficiency gains.
  • Create management reports, custom dashboards, and visualizations.
  • Conduct forecasting, sensitivity analysis, what-if scenarios, and other complex analyses.
  • Partner with cross-functional teams and manage multiple product projects simultaneously.
  • Present analyses, updates, financial risks, and recommendations to specific audiences.
  • Analyze operational, production, financial, and other data to support business performance.
  • Maintain data integrity and control over business processes through data management best practices.
  • Operationalize business intelligence solutions to support organizational goals and strategies.
  • Analyze large structured, semi-structured, and unstructured data sets to uncover insights and business value.
  • Participate in weekly meetings to review metrics, workflows, trends, and performance improvement opportunities.

Requirements

  • Bachelor’s degree in a healthcare-related field 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.
  • Proficiency with Microsoft Excel and reporting software.
  • Basic procedure coding knowledge.
  • Experience with Power BI and SQL is desired.
  • Knowledge of medical terminology, abbreviations, and healthcare nomenclature and systems.
  • Strong verbal and written communication, organizational, problem-solving, and teamwork skills.
  • Knowledge of the appeal process and procedures.
  • Ability to navigate multiple customer demands and balance competing priorities.
  • Ability to independently solve complex problems using critical thinking skills.
  • Ability to develop, implement, and produce complex analyses and reports.
  • Ability to maintain confidentiality of sensitive information.

Benefits

  • Remote office work environment.
  • Pay range of $90,000 to $112,500 USD.
  • Comprehensive medical, dental, vision, life, and disability coverage for eligible employees and dependents.
  • Free testing for employees and their immediate families.
  • Fertility care benefits.
  • Pregnancy and baby bonding leave.
  • 401(k) benefits.
  • Commuter benefits.
  • Generous employee referral program.

Interested in this position?

Apply directly on the company website

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