Senior Payer Relations Specialist

Job Summary

Focusing on increasing collections from insurance companies, the remote Senior Payer Relations Specialist will manage payor follow-up and appeals of denied claims while collaborating with cross-functional teams to enhance reimbursement strategies and resolve payor reimbursement issues.

Key Responsibilities

• Communicate effectively with payors and internal stakeholders to resolve reimbursement issues
• Support revenue growth in collaboration with the Market Access team and external billing vendors
• Stay current with payor policy changes and regulations to ensure accurate reimbursement of claims

Required Qualifications

• 5-7+ years of billing, coding, and reimbursement experience in the CLIA laboratory services sector
• Strong knowledge of Medicare, Medicaid, and private insurance reimbursement processes and regulations
• Proficient knowledge of CMS guidelines
• Ability to work independently and prioritize tasks in a fast-paced environment
• Knowledge of medical billing and coding practices and procedures