Sr Payer Policy Analyst- HYBRID

Labcorp; Raleigh, Durham (NC, NC); Hybrid; USD 76,000 - 100,000; Full time

Benefits offered by this job

Comprehensive medical benefits

401(k) plan

Tuition reimbursement

Job summary

A leading healthcare company is seeking a Senior Payer Policy Analyst to assist in policy and alliance development. This role involves advocating for company positions and improving prior authorization outcomes for genetic testing. Candidates must have a Bachelor’s degree and substantial work experience in healthcare revenue cycles and payer policies. The position is hybrid, offering a balanced work schedule with three in-office and two remote days.

Qualifications

• 5 years work experience; if no degree, 7 years required.
• Experience with state and federal agencies.
• Prior work in clinical or business settings.

Responsibilities

• Develop strategies to improve prior authorizations.
• Monitor payer policy updates and changes.
• Advocate company positions in meetings.

Skills

Strategic relationship building

Knowledge of payer policies

Healthcare revenue cycle experience

Analytical skills

Education

Bachelor’s degree

MBA or advanced degree

Job description

Sr. Payer Policy Analyst - 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 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.

Responsibilities

• Work 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 monitor payer policy updates and changes such as NCD, LCD and other commercial insurance coverage policies impacting revenue.
• Function as a liaison between Labcorp Medical Directors and Government and Commercial Payer Medical Directors on issues pertaining to existing payer policies and proposed policy changes impacting reimbursement.
• Assist the Manager 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.
• Coordinate with the Payer and Policy Relations Team to help develop LabCorp’s policy positions, strategy and tactics, and advocate company positions with regard to new or amended legislation, regulations, or public policy. Support efforts in defending against risk of Medicare and private sector payer price erosion associated with the Protecting Access to Medicare Act of 2014 (PAMA).
• Support efforts at the state and federal levels as appropriate by developing responses, talking points, strategy on key issues while helping to assure policy consistency across the organization.
• Advocate company positions orally and in writing before, during and after meetings at associations and coalitions (e.g., ACLA, CCLA, PLUGS, AECS, Medicaid Review boards, ICD-10 coalition, CMS Provider Compliance Group), and others.
• Communicate developments and updates on a regular basis through periodic reporting mechanisms and appropriate internal and external communications channels.
• Examine health care trends, monitor 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.
• Evaluate laboratory-related state legislation and laws to engage subject matter experts to determine potential impacts and next steps.
• Craft language based on state laws to assist in appealing claim denials and pursue payer reimbursement.
• Develop and maintain key contacts and relationships with policy makers for Medicare Contractors, Medicaid Payers and Commercial insurers. Collaborate with third party groups affected by Medicare, Medicaid, and CLIA regulations that impact lab services.
• Performs other duties and responsibilities as assigned by the manager, Director and/or Vice President of Payer Policy.

Qualifications

• Bachelor’s degree from an accredited four-year institution and 5 years work experience required (If no degree- minimum 7 years work experience required).
• Strong preference for advanced degree; MBA, JD, M.A./M.S., CGC, RN
• Prior experience building strategic relationships
• Prior work experience in a clinical or business setting
• Prior work experience with insurance guidelines and payer policies
• Prior work experience with state and federal agencies and/or commercial insurance payers
• Prior work experience in healthcare revenue cycle (prior authorization, coding, claims, denials, appeals, billing compliance, etc.)

Application Window Closes: 8-15-25

Pay Range: $76-100K (State minimum wages apply if higher)

Shift: Monday-Friday; 8:00am-5:00pm EST - HYBRID

This hybrid position offers a balanced schedule of three in-office days at our Burlington or Durham, NC locations and two remote workdays per week, supporting both collaboration and flexibility.

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.

Benefits: 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. Casual, PRN & Part Time employees regularly scheduled to work less than 20 hours are eligible to participate in the 401(k) Plan only.

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.

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