Market Access Payor Performance Analyst

Primary Responsibilities

● Formulates and develops presentations from project analysis.
● Recognize barriers that affect Average Sales Price (ASP) and expected revenue including
identifying trends, pull-through opportunities, and potential risks for all Natera products with each
payor.
● Compares payor reimbursement patterns based on medical policies, contract language,
authorization requirements, and patient plan coverage.
● Research complex patient benefits with in-depth insurance verification using various payor
systems, strategies, and internal external portals.
● Investigate designated payors' literature and agencies, and stay current on new indicators, such as state statutes, state/federal laws, and other requirements.
● Develops strategies to improve reimbursement and reduce denials for assigned payors based on
trends and analysis findings.
● Intrinsic knowledge of Independent Physician Association (IPAs), Managed Medicaid, and
Medical Groups, their risk relationship with their respective payor agreements, authorization
requirements, and billing requirements.
● Identifies areas of opportunities for process improvements, automation, and efficiencies.
● Creates management reports, 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, and 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.

Qualification:

● 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.

Knowledge, skills and abilities

● 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.

The pay range is listed and actual compensation packages are based on a wide array of factors unique to each candidate, including but not limited to skill set, years & depth of experience, certifications and specific office location. This may differ in other locations due to cost of labor considerations.Austin, TX$81,900—$102,350 USD

OUR OPPORTUNITY

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 institutio