Payor Performance Analyst

Job Title: Payer Performance Analyst

Company Overview: Natera, Inc. is a global leader in cell-free DNA (cfDNA) testing, specializing in oncology, women's health, and organ health. Founded in 2004 and headquartered in Austin, Texas, Natera is dedicated to making personalized genetic testing and diagnostics a standard of care, enabling earlier and more targeted interventions to improve patient outcomes. With over 250 peer-reviewed publications and more than 10 million tests processed in CAP/CLIA-certified labs, Natera continues to advance molecular diagnostics with scientific rigor and integrity.

You can read more about us at natera.com

Job Summary: We are seeking a highly analytical and detail-oriented Payer Performance Analyst to evaluate payer performance, analyze reimbursement trends, and identify opportunities to enhance revenue optimization. This role will support cross-functional teams by providing data-driven insights, developing reports and dashboards, and implementing strategies to improve reimbursement efficiency while ensuring compliance with payer policies and regulations.

Key Responsibilities:

• Develop presentations and analytical reports for Finance, Billing, Market Access, Product Leads, and other teams as needed.
• Identify functions and barriers affecting ASP (Average Sales Price) and revenue, including trends, opportunities, and risks across all payers and products.
• Compare payer reimbursement patterns based on medical policies, contract language, authorization requirements, and patient benefits.
• Research complex benefits and insurance verification using internal and external systems and portals.
• Investigate payer literature, regulations, and state statutes to stay current on reimbursement indicators, laws, and other requirements.
• Develop and implement strategies to improve reimbursement rates and reduce denials for assigned payers based on data analysis and trends.
• Identify areas for process improvements, automation, and operational efficiencies to optimize payer performance.
• Create management reports, dashboards, and data visualizations to support decision-making and performance tracking.
• Lead and support projects, initiatives, and change management efforts related to payer performance and revenue cycle optimization.
• Conduct in-depth trend analysis, forecasting, sensitivity analysis, and "what-if" scenario evaluations.
• Partner with internal cross-functional teams to manage multiple product-related projects and initiatives.
• Present analysis, insights, financial risks, and strategic recommendations to key stakeholders.
• Analyze operational, financial, and production data to assess payer behaviors and optimize reimbursement processes.
• Ensure data integrity and implement best practices for business process data management.
• Utilize business intelligence solutions to highlight strengths, opportunities, and performance improvement areas.
• Analyze large structured and unstructured datasets to extract meaningful insights and collaborate with business partners on data-driven solutions.
• Participate in weekly meetings to review key metrics, workflows, trends, payer performance improvement strategies, and opportunities.
• Maintain compliance with PHI (Protected Health Information) regulations while working with sensitive data in both paper and electronic formats.

Qualifications:

• Bachelor's degree in Finance, Business, Healthcare Administration, Data Analytics, or a related field.
• 3+ years of experience in payer analytics, revenue cycle management, or healthcare finance.
• Strong analytical and problem-solving skills with experience in data analysis and business intelligence tools (Excel, SQL, Tableau, Power BI, etc.).
• Deep understanding of payer reimbursement methodologies, insurance verification, and claims processing.
• Experience with healthcare regulatory compliance, medical policies, and payer contract analysis.
• Ability to manage multiple projects simultaneously and collaborate with cross-functional teams.
• Excellent communication and presentation skills with the ability to convey complex financial and operational insights to stakeholders.
• Strong attention to detail and ability to work independently in a fast-paced environment.

Preferred Qualifications:

• Experience with healthcare reimbursement systems and payer negotiations.
• Knowledge of federal and state healthcare regulations, including Medicare and Medicaid policies.
• Familiarity with revenue cycle management (RCM) systems and electronic health records (EHR).

If you thrive in a data-driven environment and are passionate about optimizing payer performance and financial outcomes, we encourage you to apply!

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