Sr Payer Policy Analyst- Specialty Testing - Remote

Labcorp

Jul 9, 2024

Applications are closed

Job
Full-time
Senior Level
Government & Politics
$85K - $105K
Burlington
Remote

Requirements

Minimum Degree: MS, CGC, or MSN with current RN licensure, or BS, BA or other advanced degree preferred.
Minimum Years of Experience: 5+ years of experience in a clinical and business setting with genetic experience preferred.
Working knowledge of the laboratory revenue cycle preferred.
Must Have: 2+ years appeals writing or reviewing experience.

Responsibilities

Works directly with Segment Marketing Management teams to develop an understanding of existing and emerging technologies to provide education, appeals influence and insight pertaining to payer policy.
Manage informational needs of multiple cross functional stakeholders regarding payer coverage and reimbursement policy issues and/or changes.
Serve as a point of contact within RCM Payer Policy & Relations Team for payer information, payer communication and issue identification.
Responsible for making recommendations to management and may initiate implementation of new procedures and processes related to appeals strategies.
Facilitate resolution of oncology coverage and reimbursement issues between Payers, Government agencies and LabCorp.
Extrapolate and summarize essential medical information for review, identifying denial trends by case type and payer-specific issues.
Work with Policy Reporter data to understand changes in payer policy impacting reimbursement.
Collaborate with other departments/business associates to analyze, understand, and define business rules for specialty testing policy changes.
Collaborate with Prior Authorization teams to deploy best practices to support reimbursement capture.
Apply critical reasoning to assess the need for formal appeal of clinical denials and collaborate with stakeholders to draft templates for customized appeals by tumor types.
Exceptional writing skills in crafting effective payer appeal letters for oncology denials to include supportive clinical evidence, complying with all clinical and billing policies, guidelines and regulations.
Conduct clinical evidence searches, utilize internal and external subject matter experts and/or other avenues of research to identify supportive evidence for coverage of specialty testing.
Effectively communicate developments and updates on a regular basis through periodic reporting mechanisms and appropriate internal and external communication channels. Assists in advocating company positions both written and orally.
Maintain a thorough knowledge of regulatory processes and policy developments on matters affecting specialty testing. Communicate LabCorp’s policy positions, strategy and tactics, and advocate oncology positions with regard to new or amended legislation, regulations, or public policy.
Develop and maintain key contacts and relationships with policy makers for Medicare contractors, Medicaid payers and Commercial insurers. Ability to collaborate with third party groups affected by coverage and reimbursement policies, guidelines and regulations that impact oncology services.
Support 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.
Perform other and further duties and responsibilities as assigned.

FAQs

What is the main responsibility of the Senior Payer Policy Analyst for Specialty Testing at Labcorp?

The main responsibility is to support precision medicine products by developing policy and alliance activities, implementing clinical appeal strategies to impact reimbursement, and influencing payer policy for next-generation sequencing assays.

What qualifications are required for this position?

A minimum of a Master's degree (MS, CGC, or MSN with RN licensure) or a Bachelor's degree is preferred, along with 5+ years of experience in a clinical and business setting, ideally with genetic experience. At least 2 years of appeals writing or reviewing experience is a must.

Is prior experience in the laboratory revenue cycle important for this role?

Yes, working knowledge of the laboratory revenue cycle is preferred for this position.

What kind of writing skills are necessary for this job?

Exceptional writing skills are required for crafting effective payer appeal letters for oncology denials, which must include supportive clinical evidence and comply with relevant clinical and billing policies.

Will travel be required for this job?

Yes, the position may require travel of up to 20% to meet face-to-face with payers, industry leaders, and LabCorp specialty testing and RCM business units.

What are the main duties associated with this role?

Some key duties include collaborating with various stakeholders on payer coverage and reimbursement policies, facilitating resolution of coverage issues, analyzing denial trends, and advocating company policy positions.

What is the application window for this position?

The application window closes on July 11, 2024.

What is the pay range for the Senior Payer Policy Analyst position?

The pay range for this position is between $85,000 and $105,000.

What types of benefits are offered to employees in this position?

Comprehensive benefits include medical, dental, vision, life insurance, short-term and long-term disability, a 401(K) plan, Employee Stock Purchase Plan (ESPP), paid time off (PTO), flexible time off (FTO), commissions, and applicable bonuses.

How does Labcorp ensure equal opportunity in its hiring practices?

Labcorp is proud to be an Equal Opportunity Employer, committing to workplace diversity and inclusivity.

Labcorp

In Pursuit of Answers

Science & Healthcare

Industry

10,001+

Employees

1978

Founded Year

Mission & Purpose

Clear and confident health care decisions begin with questions. At Labcorp, we’re constantly in pursuit of answers. With unparalleled diagnostics and drug development capabilities, we accelerate innovation and provide insight to improve health and improve lives. Whether you’re a patient, provider, researcher or in the pharmaceutical industry, we’re here for you. More than 70,000 employees strong, we serve clients in more than 100 countries. Labcorp (NYSE: LH) reported revenue of $14 billion in FY 2020.