Laboratory Reimbursement Manager

The Laboratory Reimbursement Manager serves as the primary resource for reimbursement data for our clients. The role requires experience in medical laboratory coding and billing along with high-level analytical skills. The ability to review third party medical policies and determine coverage and reimbursement is critical in this role.

Responsibilities

• Customer facing role responsible for the execution of reimbursement strategies of medical laboratory tests.

• Key functions to include coding and payment analysis, insurance authorization, coverage and cost effectiveness analysis as well as collaborating/building relationships with internal and external customers.

• Provide strategic expertise to consulting clients regarding reimbursement.

• Builds and formulates collaborative relationships with other departments and serve as a liaison to external stakeholders.

• Provide expertise on state and federal regulations for reimbursement methodologies and appropriate coding for medical laboratory testing.

• Monitors, interprets, and summarizes changes in the external environment (regulatory/reimbursement changes, managed care arrangements, etc.) produces internal communication strategies on threats and opportunities with suggested action plans .

• Is the internal and external subject matter expert on market access, reimbursement and medical policy matters related to medical laboratory testing.

• Bachelor's degree required.

• Experience: 10 years of laboratory and third-party medical billing experience.

• Successful performance in this position requires a broad-based knowledge in medical laboratory reimbursement, patient access, payer coverage policy, employee management, business management, project management, and extensive experience in general healthcare.

• Strong communication, interpersonal, and analytical skills.

• The candidate must have excellent leadership qualities.

• Soft Skills: Persuasive, self-driven and motivated.

• Strong analytical and presentation skills, innovative and resourceful.

• Ability to communicate effectively, both written and orally.

• Ability to drive appropriate payment coverage of IVP products by payers.

• Computer Skills: Proficient in use of Microsoft PowerPoint, Excel, Windows and Microsoft Office.