Job Description
At Adaptive, we’re Powering the Age of Immune Medicine. Our goal is to harness the power of the adaptive immune system to transform the way diseases are diagnosed and treated. As an Adapter, you’ll have the opportunity to make a difference in people’s lives. With Adaptive, you’ll create a career highlight through collaboration with bright, curious colleagues working at the apex of innovation and application. It’s time for your next chapter. Discover your story with Adaptive. Position Overview The Sr Payer Relations Specialist will focus on increasing collections from insurance companies by effectively managing payor follow-up and appeals of denied claims. This position will analyze and resolve payor reimbursement issues through in-depth research and analysis of claim data, payor policies, regulations, and coverage criteria. This position will work in collaboration with the Market Access team, other cross-functional partners and Adaptive’s revenue cycle providers to develop and implement strategies for achieving maximal reimbursement and cash recovery from commercial payors. This role will help manage the operational and administrative processes for coding, billing, and payor follow-up - including overseeing appeals, development requests, and payor projects. Key Responsibilities and Essential Functions Communicate effectively with payors and internal stakeholders to resolve reimbursement issues and ensure optimal payment for Adaptive’s clinical products. Support revenue and ASP growth in collaboration with the Market Access team and external billing vendor Stay current with payor policy changes and regulations to ensure accurate and timely reimbursement of claims. Provide support and guidance to clinical and administrative staff on reimbursement and compliance issues. Review claims and supporting clinical documents for billing and coding accuracy. Remains knowledgeable on third-party requirements, and regulatory guidelines at the federal, state, and local levels Supp
