What are the responsibilities and job description for the Clinical Laboratory Fee Schedule SME position at Cbase Inc?
Hiring: Subject Matter Expert (SME) – Clinical Laboratory Fee Schedule (CLFS)
📍 Location: Remote (U.S.) with occasional travel to Woodlawn, MD
🇺🇸 Eligibility: U.S. Citizen or Legal Permanent Residen
tWe are seeking an experienced Subject Matter Expert (SME) – Clinical Laboratory Fee Schedule (CLFS) to support the CMS Fee-for-Service Data Collection System (FFSDCS) program. This role will serve as the primary expert on CLFS policy, PAMA reporting requirements, and Medicare Part B laboratory reimbursement, acting as the bridge between CMS policy stakeholders and technical development teams
.Key Responsibilities
:✔ Interpret and apply PAMA Section 216, CLFS regulations, and CMS guidanc
e✔ Translate policy and regulatory requirements into business and system requirement
s✔ Define data validation rules, reporting workflows, and acceptance criteri
a✔ Support CLFS data collection, validation, weighted median calculations, and rate publication processe
s✔ Review test cases, participate in UAT, and support production release
s✔ Provide Tier 3 support for complex policy and reporting inquirie
s✔ Develop user guides, training materials, and stakeholder communication
s✔ Support CMS compliance, ATO activities, and security assessment
sRequired Qualifications
:✔ Bachelor's degree in Health Policy, Public Health, Healthcare Administration, Economics, Life Sciences, or related fiel
d✔ 7 years of Medicare Part B payment policy, clinical laboratory reimbursement, or healthcare payment systems experienc
e✔ 3 years of direct experience with CLFS, PAMA reporting, or clinical laboratory billing operation
s✔ Strong understanding of HCPCS/CPT laboratory coding, CLFS rate-setting methodology, CDLTs, and ADLT
s✔ Experience translating regulations into business and technical requirement
s✔ Experience supporting CMS or other federal healthcare program
sPreferred Qualifications
:✔ Master's degree (MPH, MHA, MPP, or related field
)✔ Prior CMS payment system experience (CLFS, PFS, OPPS, ASP, AFS
)✔ Clinical laboratory reimbursement or compliance experienc
e✔ Familiarity with CMS Enterprise Portal, IDM/EIDM, CFACTS, ARS, and CMS XLC processe
s✔ Experience with Agile/Scrum and Section 508 complianc