Associate Director, Billing Strategy - Denials & Appeals

23 hours, 18 minutes ago
Full-time
Lead
Operations
Natera

Natera

Natera specializes in cell-free DNA testing, providing advanced genetic testing services for oncology, women's health, and organ health to help families diagnose and manage genetic diseases.

Pharmaceuticals
1K-5K
Founded 2004

Description

  • Lead denial management and appeals strategy across payer types.
  • Track overturn rates, appeal timelines, recovery performance, and denial trends.
  • Advise teams on payer policies, medical necessity criteria, and appeal strategy.
  • Oversee BPO and outsourced RCM vendor performance, accountability, and process improvements.
  • Partner with eligibility, prior authorization, coding, and billing teams to prevent denials.
  • Translate denial workflows into system requirements, routing rules, and appeal triggers.
  • Support rules engines, RPA, AI-driven workflows, and scalable low-touch processes.
  • Lead UAT and QA for billing system changes and automation deployments.
  • Analyze denial drivers and financial impact using Power BI, SQL, Excel, or Snowflake.
  • Develop standardized workflows, job aids, and improvements based on root-cause analysis.

Requirements

  • 8–12+ years of healthcare Revenue Cycle Management experience focused on denials and appeals.
  • Expertise in laboratory billing, CPT coding, and reimbursement methodologies.
  • Strong knowledge of commercial, Medicare, Medicaid, and managed care payer policies.
  • Demonstrated success improving appeal overturn rates and resolving medical necessity denials.
  • Experience managing or partnering with BPO or offshore RCM vendors.
  • Strong analytical skills using Power BI, Excel, SQL, or Snowflake.
  • Experience leading cross-functional initiatives and influencing stakeholders without direct authority.
  • Experience supporting revenue-cycle automation, rules engines, RPA, or workflow automation tools preferred.
  • Experience partnering with engineering teams or vendors on billing system enhancements preferred.
  • Familiarity with AMD or similar billing platforms, Jira, and AI-driven workflow concepts preferred.

Benefits

  • Remote USA role.
  • Salary range of $132,100–$165,100.
  • Medical, dental, vision, life, and disability insurance for eligible employees and dependents.
  • Free testing for employees and immediate family members, plus fertility care benefits.
  • Pregnancy and baby bonding leave.
  • 401(k) and commuter benefits.
  • Employee referral program.

Interested in this position?

Apply directly on the company website

Apply Now

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