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Senior Payer Policy Analyst- REMOTE

Roles & Responsibilities

  • Bachelor’s degree with 5+ years of relevant work experience, or an Associate degree with 7+ years of relevant experience, or a High School diploma with 9+ years of relevant experience.
  • Preferred advanced degree and/or professional certifications (e.g., MBA, JD, MA/MS, CGC, RN).
  • Three+ years of experience with state and federal agencies and/or commercial insurance payers.
  • Three+ years of experience in healthcare revenue cycle (prior authorization, coding, claims, denials, appeals, billing compliance).

Requirements:

  • Collaborate with Segment Science and Marketing management to understand existing and emerging technologies and provide education, appeals influence and insight pertaining to payer policy for Government and Commercial payers.
  • Attend payer meetings with Payor Solutions Account Executives to communicate specific policy concerns and denial trends.
  • Monitor payer policy updates (NCD, LCD, and other commercial insurance coverage policies) impacting reimbursement; function as a liaison between Labcorp Sales, Medical Directors, and Government and Commercial Payer Medical Directors on policy changes.
  • Assist the Manager with subject matter expertise for developing comments on regulatory proposals, written testimony, policy position papers and regulations; analyze public policy, legislative and regulatory proposals, and reporting internally as required.

Job description

Labcorp is seeking a REMOTE Senior Payer Policy Analyst  to join our team!

Work Schedule: Monday – Friday; 8:00am-5:00pm EST

 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 commercial insurance coverage policies impacting reimbursement.

  • Functions as a liaison between Labcorp Sales, 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(s) 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.

  • Collaborates with Sales and client accounts as a subject matter expert on payer policies and prior authorization requirements.

  • 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

  • Develops and maintains key contacts within Labcorp’s Sales leadership and Payor Solutions leadership to collaboratively address and improve reimbursement for medically necessary testing performed.

  • Performs other and further duties and responsibilities as shall be assigned by the manager, Director and/or Vice President of Payer Policy.

Minimum Qualifications:

Bachelor’s degree and 5 years work experience required or Associate degree with 7 years relevant work experience or High School diploma with 9 years relevant work experience required

Preferred Qualifications:

  • Certified Genetic Counselor
  • Advanced degree; MBA, JD, M.A. / M.S., CGC, RN
  • Three or more years work experience with state and federal agencies and/or commercial insurance payers
  • Three or more years work experience in healthcare revenue cycle (prior authorization, coding, claims, denials, appeals, billing compliance, etc.)

Additional Job Standards:

  • Prior experience building strategic relationships
  • Prior work experience in a clinical or business setting

At Labcorp, you are part of a journey to accelerate life-changing healthcare breakthroughs and improve the delivery of care for all.  You’ll be inspired to discover more, develop new skills and pursue career-building opportunities as we help solve some of today’s biggest health challenges around the world.  Together, let’s embrace possibilities and change lives!

The Senior Payer Policy Analyst is responsible for assisting the Manager of Payer Policy and Relations with policy and alliance development activities for the company, including assistance with development and implementation of policy strategies to support Labcorp and the laboratory industry at the state and federal levels.  The Analyst will act as internal conduit to gather and share information as it relates to policy, billing and reimbursement issues. The Analyst will primarily focus on developing and implementing strategies to improve the outcomes of prior authorizations for genetic testing. 

Application Window Closes: 4-11-26

Pay Range: $75-$100K  

All job offers will be based on a candidate’s skills and prior relevant experience, applicable degrees/certifications, as well as internal equity and market data. 

Employees regularly scheduled to work 20 or more hours per week are eligible for comprehensive benefits including: Medical, Dental, Vision, Life, STD/LTD, 401(k), Paid Time Off (PTO) or Flexible Time Off (FTO), Tuition Reimbursement and Employee Stock Purchase Plan. Employees regularly scheduled to work less than 20 hours, Casual, Intern, and Temporary employees are only eligible to participate in the 401(k) Plan. Employees who are regularly scheduled to work a 7 on/7 off schedule are eligible to receive all the foregoing benefits except PTO or FTO. For more detailed information, please click here. 

Labcorp is proud to be an Equal Opportunity Employer:

Labcorp strives for inclusion and belonging in the workforce and does not tolerate harassment or discrimination of any kind. We make employment decisions based on the needs of our business and the qualifications and merit of the individual. Qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, sex (including pregnancy, childbirth, or related medical conditions), family or parental status, marital, civil union or domestic partnership status, sexual orientation, gender identity, gender expression, personal appearance, age, veteran status, disability, genetic information, or any other legally protected characteristic. Additionally, all qualified applicants with arrest or conviction records will be considered for employment in accordance with applicable law. 

We encourage all to apply

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