[Hiring] Market Access Payor Analyst @Natera

Role Description

The Market Access Payor Analyst is responsible for profiling, researching, and resolving reimbursement issues for assigned payors, products, or lines of business. This position performs analysis, identifies trends, presents opportunity areas, and prioritizes initiatives for payment and performance improvement. Using data analytics, they derive logical conclusions and forecasts from implementing strategies that can improve business performance.

• Formulates and develops presentations for project analysis needs from Finance, Billing, Market Access, Product Leads, and other teams as required.
• Identify functions and barriers that affect ASP and revenue including identifying trends, opportunities, and risks for all payors and products.
• Compares payor reimbursement patterns based on medical policies, contract language, authorization requirements, and patient benefits.
• Researches complex benefits and insurance verification using various systems and portals internal and external.
• Investigate designated payors' literature and agencies, and stay current on new indicators, such as state statutes, laws, and other requirements.
• Develops strategies to improve reimbursement and reduce denials for assigned payors based on trends and analysis findings.
• Identifies areas of opportunities for process improvements, automation, and efficiencies.
• Creates management reports and custom dashboards & visualizations.
• Initiates and supports projects, initiatives, solutions, and other change management.
• Conducts complex trend review, forecasting, sensitivity analysis, what-if scenarios, and other analyses.
• Partner with multiple internal cross-functional teams and successfully manage multiple product projects simultaneously.
• Presents information, analysis, updates, financial risks, and recommendations to a specific audience.
• Performs analysis of operational, production, financial, and other data.
• Analyzes payor behaviors, systems, and processes in reimbursement to optimize performance.
• Ensure data integrity and control over business processes by developing data management best practices.
• Operationalize business intelligence solutions to highlight strengths and opportunities to meet organizational strategies, objectives, and goals.
• Analyze large data sets of structured, semi-structured unstructured data to discover data insights and collaborate with business partners to deliver business value.
• Participates in weekly meetings to review key metrics, workflows, trends, payor performance improvement opportunities, and strategies.
• This role works with PHI regularly both in paper and electronic form and has access to various technologies to access PHI (paper and electronic) to perform the job.

Qualifications

• 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.

Requirements

• 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.
• Strong communication (verbal and written), organizational, problem-solving, and team player skills.
• Knowledge of the appeal process and procedures.
• Ability to navigate across multiple customer demands and balance competing priorities successfully.
• Ability to analyze, identify, and articulate identified trends and report trends succinctly, clearly, and concisely.
• Ability to independently solve complex problems using critical thinking skills.
• Maintains confidentiality of sensitive information.
• Analytical skills required.
• Ability to develop, implement, and produce complex analyses and reports.

Benefits

• Competitive Benefits - Employee benefits include comprehensive medical, dental, vision, life and disability plans for eligible employees and their dependents.
• Natera employees and their immediate families receive free testing in addition to fertility care benefits.
• Other benefits include pregnancy and baby bonding leave, 401k benefits, commuter benefits, and much more.
• Generous employee referral program.

Company Description

Natera™ is a global leader in cell-free DNA (cfDNA) testing, dedicated to oncology, women’s health, and organ health. Our aim is to make personalized genetic testing and diagnostics part of the standard of care to protect health and enable earlier and more targeted interventions that lead to longer, healthier lives.

The Natera team consists of highly dedicated statisticians, geneticists, doctors, laboratory scientists, business professionals, software engineers, and many other professionals from world-class institutions, who care deeply for our work and each other. When you join Natera, you’ll work hard and grow quickly. Working alongside the elite of the industry, you’ll be stretched and challenged, and take pride in being part of a company that is changing the landscape of genetic disease management.