[Remote] Associate Director, Denials and Appeals at Natera

United States

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Not SpecifiedCompensation

Senior (5 to 8 years), Expert & Leadership (9+ years)Experience Level

Full TimeJob Type

UnknownVisa

Healthcare, Medical BillingIndustries

Requirements

Full understanding of Natera’s billing information system and all aspects of revenue cycle management
Experience leading billing, collection, and accounts receivable management teams
Knowledge of third-party contract terms including Medicare, Medicaid, managed care, commercial insurance, and direct patient pay
Ability to analyze reimbursement, exception reporting, pending claims, and denials management
Expertise in medical billing code tables (CPT and ICD-10), rate schedules, and payer information
Proficiency in preparing detailed analyses, reports, performance metrics, bad debt expense, and AR days outstanding
Skills in budgeting, forecasting headcount, and cash receipts
Experience interfacing with third-party payers to resolve reimbursement issues and contracting challenges
Participation in compliance committees for coding and billing

Responsibilities

Directs Denials and Appeals management and staff to ensure accurate claim submission and timely collections per contract terms
Establishes and maintains billing and financial data, including code tables, rate schedules, and payer information
Analyzes reimbursement from all sources, including exception reporting, pending claims, and denials management
Maximizes cash collections through monitoring open accounts receivable balances
Maintains and enhances billing policies and procedures, ensuring staff adherence
Prepares detailed analyses and reports on billing, accounts receivable activity, performance metrics, bad debt, and AR days
Manages continuous improvements in the revenue cycle process
Interacts effectively with various functional areas
Provides mentoring, coaching, performance reviews, hiring, orientation, training, development, corrective actions, and monitoring for direct reports
Ensures consistent quality of billing services by assigning duties, matching skills to tasks, and monitoring productivity
Leads high-performance team for Data Entry, CPT/ICD-10 Coding, Cash Posting, Denial/AR Management, Refunds Processing, and Call Center Operations
Provides leadership, drives change, and facilitates process improvements
Collaborates with RCM Finance on billing analysis for financial reporting, sales/marketing on clients, and senior management on performance/initiatives
Participates in Compliance Committee, establishes/enforces policies and procedures
Develops/monitors operating procedures and implements workflow changes for productivity
Drafts budgeting and forecasting for headcount and cash receipts
Holds billing leadership accountable for performance and production standards
Maintains billing-related quality patient outcomes
Conducts annual performance evaluations, hiring decisions, and corrective action plans
Interfaces with third-party payers to resolve issues and guides senior leadership on contracting
Provides direction and development through daily coaching, performance management, and development plans
Assesses performance and provides timely, constructive feedback to staff

Skills

Key technologies and capabilities for this role

Denials ManagementAppeals ManagementRevenue Cycle ManagementBilling SupervisionAccounts ReceivableClaims SubmissionReimbursement AnalysisPayer ContractsMedicare BillingManaged CareAR ReportingBad Debt Management

Questions & Answers

Common questions about this position

What teams or functions does this role lead?

The role leads teams responsible for Data Entry, CPT and ICD-10 Coding, Cash Posting, Denial and Accounts Receivable Management, Refunds Processing, and Call Center Operations, while directing Denials and Appeals management and staff.

What are the key responsibilities in denials and appeals?

The role directs Denials and Appeals management and staff to ensure accurate claim submissions and timely collections per third-party contract terms, including Medicare, Medicaid, managed care, commercial insurance, and direct patient pay.

What leadership skills are needed for this position?

The role requires skills in daily supervision, mentoring, coaching, performance reviews, hiring, training, development, and leading high-performance teams while driving change and process improvements.

Is this a remote position or does it require office presence?

This information is not specified in the job description.

What is the salary or compensation for this role?

This information is not specified in the job description.

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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