Labcorp · 17 hours ago
Sr. Payer Policy Analyst- Genetic Counseling/Prior Authorization REMOTE
United States
Full-time
Remote
Senior Level
$76K/yr - $100K/yr
5+ years expLabcorp is dedicated to accelerating healthcare breakthroughs and improving care delivery. The Senior Payer Policy Analyst will assist in developing and implementing policy strategies, acting as a liaison for policy, billing, and reimbursement issues.
BiotechnologyHealth CareHospitalLife ScienceMedicalPrecision Medicine
Hiring Manager
Missy Meurer
Responsibilities
Works directly with Segment Science and Marketing management teams to develop an understanding of existing and emerging technologies to provide education, appeals influence and insight pertaining to payer policy for Government and Commercial payers
Provide support to include attending Payer meetings with Payor Solutions Account Executives to communicate specific policy concerns and denials trends
Regularly monitors payer policy updates and changes such as NCD, LCD and other coverage policies impacting revenue
Functions as a liaison between LabCorp Medical Directors and Government and Commercial Payer Medical Directors on issues pertaining to existing payer policies and proposed policy changes impacting reimbursement
Will assist the Manager with subject matter expertise for the development of comments on regulatory proposals, written testimony, policy position papers and regulations that affect the company, analyzing public policy, legislative and regulatory proposals, and reporting internally as required
Coordinates with the Payer and Policy Relations Team to help develop LabCorp’s policy positions, strategy and tactics, and advocates company positions with regard to new or amended legislation, regulations, or public policy. Helps support efforts in defending against risk of Medicare and private sector payer price erosion associated with the Protecting Access to Medicare Act of 2014(PAMA)
Supports efforts at the state and federal levels as appropriate by developing responses, talking points, strategy on key issues while helping to assure policy consistency across the organization
Assists in advocating company positions orally and in writing before, during and after meetings at ACLA (the clinical laboratory trade association), with other trade and professional associations, with laboratory coalitions (e.g., CCLA, PLUGS, AECS, Medicaid Review boards, ICD-10 coalition, CMS Provider Compliance Group), and others
Communicates developments and updates on a regular basis through periodic reporting mechanisms and appropriate internal and external communications channels
Examines health care trends, monitors implementation of Government Health Care Acts to inform business of implications and identify potential opportunities and/or risk for Medicare, Medicaid, Accountable Care Organizations, and Commercial payers
Evaluates laboratory-related state legislation and laws to engage subject matter experts to determine potential impacts and next steps
Crafts language based on state laws to assist in appealing claim denials and pursue payer reimbursement
Develops and maintains key contacts and relationships with policy makers for Medicare Contractors, Medicaid Payers and Commercial insurers. Ability to collaborate with third party groups affected by Medicare, Medicaid, and CLIA regulations that impact lab services
Performs other and further duties and responsibilities as shall be assigned by the manager, Director and/or Vice President of Payer Policy
Qualification
Required
Bachelor's degree from an accredited four-year institution and 5 years relevant work experience required (If no degree- minimum 7 years work experience required)
Prior Genetic Counseling and prior authorizations work experience required
Prior work experience in a clinical or business setting
Prior work experience with insurance guidelines and payer policy
Prior work experience with state and federal agencies and commercial insurance payers
Prior work experience in healthcare revenue cycle (prior authorization, coding, claims, denials, appeals, billing compliance, etc.)
Preferred
Advanced degree; MBA, JD, M.A. / M.S., CGC, RN
Benefits
Medical
Dental
Vision
Life
STD/LTD
401(k)
Paid Time Off (PTO)
Flexible Time Off (FTO)
Tuition Reimbursement
Employee Stock Purchase Plan
Company
Labcorp
Labcorp specializes in providing physicians with laboratory tests.
10001+ employees
Funding
Current Stage
Public CompanyTotal Funding
$2.85B2024-09-16Post Ipo Debt· $2B
2019-06-04Post Ipo Debt· $850M
1988-07-15IPO
Leadership Team
Adam Schechter
President and Chief Executive Officer
Bill Haas
SVP, Northeastern US and Canada, Labcorp Diagnostics
Recent News
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