Senior Payer Relations Specialist

Job Summary

A company is looking for a Senior Payer Relations Specialist to manage payor follow-up and appeals of denied claims, focusing on increasing collections from insurance companies.

Key Responsibilities

• Communicate with payors and internal stakeholders to resolve reimbursement issues
• Collaborate with the Market Access team to support revenue and ASP growth
• Analyze claims data and payor policies to ensure accurate reimbursement

Required Qualifications

• 5-7+ years of billing, coding, and reimbursement experience, preferably in CLIA laboratory services
• Strong knowledge of Medicare, Medicaid, and private insurance reimbursement processes
• Proficient knowledge of CMS guidelines
• Knowledge of medical billing and coding practices and procedures
• Strong computer skills, including proficiency in Microsoft Office and healthcare billing software