[Remote] Associate Director, Denials and Appeals at Natera

United States

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Not SpecifiedCompensation

N/AExperience Level

N/AJob Type

Not SpecifiedVisa

N/AIndustries

Requirements

Bachelor's degree in Business Administration, Healthcare Administration, or related field
5+ years of experience in a leadership role in a revenue cycle management environment
Strong understanding of Natera's billing information system and all aspects of revenue cycle management
Experience with Medicare, Medical, managed care, commercial insurance, and direct patient pay
Strong analytical and problem-solving skills
Excellent communication and leadership skills
Ability to manage and lead a high-performance team
Experience with budgeting and forecasting
Strong knowledge of medical billing code tables, rate schedules, and payer information
Ability to analyze reimbursement from all sources and follow up on pending claims

Responsibilities

Directs Denials and Appeals management and staff to ensure accurate submission of all claims and timely collections
Establishes and maintains all billing and financial data, including medical billing code tables, rate schedules, and payer information
Analyzes reimbursement from all sources, including carrier reimbursement exception reporting and follow-up pending claims analysis and denials management
Assures maximization of cash collections through diligent and timely monitoring of all open accounts receivable balances
Maintains and enhances billing policies and procedures for each function in the revenue cycle process
Prepares detailed analyses and reports of billing and accounts receivable activity and results
Manages for continuous improvements within the revenue cycle process
Effectively interacts with various functional areas, including RCM (Billing) Finance, sales and marketing, and senior management
Provides mentoring, coaching, and performance reviews for direct reports
Manages all outreach billing operations, including hiring, orientation, training, development, coaching, corrective actions, and ongoing monitoring of all staff work-related activities
Ensures consistent quality of the billing services by distributing and assigning duties and responsibilities to employees
Leads a high-performance team responsible for various billing operations
Provides leadership, drives change, and facilitates process improvements
Actively collaborates with the RCM (Billing) Finance team on analysis of billing activity for monthly financial reporting
Participates in the Compliance Committee for Coding and Billing related items
Develops and monitors operating procedures and implements changes in workflow to improve productivity
Drafts accurate budgeting and forecasting of headcount and cash receipts
Creates and holds billing leadership accountable for established performance and production standards
Maintains billing related quality patient outcomes
Conducts annual performance evaluations, makes hiring decisions, and develops corrective action plans when necessary
Interfaces with third-party payers to resolve reimbursement issues and provides guidance to senior leadership regarding contracting challenges
Provides direction to and development of associates through daily coaching and the administration of Performance Management

Skills

Natera

Genetic testing and diagnostics solutions provider

About Natera

Natera focuses on genetic testing and diagnostics, providing advanced solutions for cancer patients, transplant patients, and individuals assessing hereditary health risks. Their main technology is cell-free DNA (cfDNA) testing, which analyzes DNA fragments in the blood to detect minimal traces of cancer and assess organ health. Natera stands out by offering specialized tests like the Signatera ctDNA test and Panorama NIPT, along with genetic counseling services. The company's goal is to improve patient care and health outcomes through accurate genetic testing.

Austin, TexasHeadquarters

2004Year Founded

$149.9MTotal Funding

IPOCompany Stage

Biotechnology, HealthcareIndustries

1,001-5,000Employees

Benefits

Flexible medical plans

Investment options

Time off

Workplace perks

Risks

Hindenburg report accuses Natera of deceptive sales practices, risking legal challenges.

New Prospera Heart features may face slow adoption by healthcare providers.

Fetal RhD NIPT demand may drop post-RhIg shortage, affecting future sales.

Differentiation

Natera's Signatera test offers personalized ctDNA analysis for cancer patients.

Prospera Heart test uses unique Donor Quantity Score for transplant rejection detection.

Panorama NIPT test is a leader in non-invasive prenatal testing with 2 million tests.

Upsides

Increased adoption of liquid biopsy techniques boosts demand for Natera's cfDNA tests.

AI integration enhances accuracy and speed of Natera's cfDNA analysis.

Growing personalized medicine trend aligns with Natera's customized genetic tests.

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