Natera dezvoltă teste pentru ADN-ul liber circulant și soluții de bioinformatică pentru domeniul sănătății. Tehnologiile sale de diagnostic susțin screeningul prenatal neinvaziv, depistarea cancerului și monitorizarea transplanturilor de organe, ajutând medicii și pacienții să acceseze informații genetice pentru decizii de îngrijire mai bine fundamentate. Activitatea companiei reunește biotehnologia, analiza datelor și aplicațiile clinice în mai multe domenii ale medicinei moderne.
Associate Director, Billing Strategy - Denials and Appeals (Remote, United States)
Lead denial and appeals strategy at Natera, a global cell-free DNA testing company. Use payer advocacy, analytics, and billing automation to improve reimbursement outcomes.
Statele Unite ale Americii132.100 $ – 165.100 $ / an
RemoteNormă întreagăSeniorLimbă Obligatorie: englezăSpecialist în facturareDescriere
- Own denial management and appeals strategy across all payer categories
- Establish and monitor overturn rates, appeal timelines, and recovery results
- Act as the internal authority on payer policies and laboratory-testing medical necessity criteria
- Interpret payer requirements and help teams substantiate medical necessity during appeals
- Analyze payer behavior to support contracting decisions and escalation strategies
- Collaborate with eligibility, prior authorization, coding, and billing teams to prevent denials proactively
- Review BPO and vendor performance, close workflow gaps, reinforce accountability, and implement improvements
- Create practical job aids and standardized operating procedures
- Assess denial patterns to separate preventable operational issues from systemic or payer-related problems
- Convert denial and appeals processes into system logic with engineering teams and vendors
- Specify rules-based workflow, denial-routing, and appeal-trigger requirements for billing platforms such as AMD
- Contribute to rules-engine, RPA, and AI-enabled workflow automation programs
- Direct user acceptance testing and quality assurance for system updates
- Find opportunities to move processes into scalable, low-touch, or unattended workflows
- Anticipate automation edge cases, failure modes, and logic gaps before and after launch
- Use Power BI, SQL, Excel, or Snowflake to measure denial causes and financial impact
Cerințe
- Bring 8–12 or more years of healthcare Revenue Cycle Management experience, with substantial denials and appeals expertise
- Demonstrate expertise in laboratory billing, CPT coding, and reimbursement methods
- Understand commercial, Medicare, Medicaid, and managed-care payer policies in depth
- Show a record of improving appeal overturn rates and resolving medical necessity denials
- Have experience working with BPO or offshore revenue-cycle vendors
- Use Power BI, Excel, SQL, or Snowflake effectively for analysis
- Lead cross-functional programs and influence stakeholders without direct reporting authority
- Preferred: experience supporting revenue-cycle automation programs
- Preferred: experience collaborating with engineering teams or vendors on billing-system enhancements
- Preferred: familiarity with AI-enabled workflow concepts
- Preferred: experience with AMD or a comparable billing platform
- Preferred: experience using Jira or a similar workflow-management system
Beneficii
- Comprehensive medical, dental, vision, life, and disability coverage is available to eligible employees and dependents
- Complimentary testing is available for employees and their immediate families
- Fertility-care benefits
- Pregnancy and baby-bonding leave
- 401(k) benefits
- Commuter benefits
- Employee referral program
- Equal Opportunity Employer with an inclusive workplace