Market Access Payor Analyst
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Job Description
Market Access Payor Analyst at Natera responsible for reimbursement issue resolution and performance improvement through data analytics. Analyzes trends and collaborates with cross-functional teams on initiatives.
Responsibilities:
- 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!
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