Manager, Market Access Liaison
New
A
AbbottCancer diagnostics
United States of America : RemoteFull-TimeManager
Salary99,300 - 198,700 USD per year
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Job Details
- Experience
- 8+ years of experience in market access, payer strategy, reimbursement, revenue cycle, or billing management within the healthcare services industry.
- Required Skills
- HIPAA
Requirements
- Bachelor’s degree in business, finance, or a related field, or a high school degree/general education diploma and 4 years of relevant experience in lieu of a bachelor’s degree.
- 8+ years of experience in market access, payer strategy, reimbursement, revenue cycle, or billing management within the healthcare services industry.
- Working knowledge of the genomic, diagnostic, or oncology environment.
- Working knowledge of commercial and government payers, reimbursement processes, payer policies, and claims performance.
- Understand applicable healthcare billing regulations and apply them to new processes and policies.
- Know basic coding conventions and use coding nomenclature consistent with CMS Official Guidelines for Coding and Reporting ICD-9-CM/ICD-10-CM.
- Maintain working knowledge of EOBs, payer policies, contracting and coverage changes, ABN requirements, the Medicare 14-day rule, ICD-10, CPT and HCPCS coding, accounts receivable, HIPAA, and EDI claims submission methods.
- Apply analytical, problem-solving, project management, and stakeholder-management skills.
Responsibilities
- Monitor payer, claims, reimbursement, and billing performance.
- Investigate and prioritize issues based on claim volume, financial impact, recurrence, and potential effects on patient access or reimbursement.
- Coordinate resolution strategies across Key Account Managers, Revenue Cycle, field sales, analytics, appeals, Legal, Compliance, and external billing partners.
- Support out-of-network payer strategies and ADLT collection and reporting processes as needed.
- Provide reimbursement and billing guidance, education, tools, and issue support to field sales and Key Account Managers.
- Support payer outreach and translate recurring issues into process improvements, policy clarification, and targeted education.
- Support appeal strategy for strategic payers and complex reimbursement issues.
- Assess intervention effectiveness quarterly and communicate issue status, actions, outcomes, and recommendations to leadership and business partners.
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