Director, Revenue Cycle Billing Strategy

Position Overview

• Location Type: Not specified
• Employment Type: Not specified
• Salary: Not specified
• Job Type: Director
• Brief Description: The Director of Billing Strategy will lead strategic improvements within Natera’s revenue cycle processes, overseeing product reimbursement and revenue cycle operations to impact financial performance. This role will work across departments to integrate RCM knowledge with process improvements, data analysis, and strategic initiatives.

Primary Responsibilities

• Manages revenue cycle projects related to specific products by identifying opportunities for process improvement.
• Redesign processes and documentation of SOPs, implementation of new workflows, and monitoring of operational metrics.
• Serves as a source of subject matter expertise and performs analysis, identifies trends, presents solutions and insights, and prioritizes initiatives for process and performance improvement.
• Responsible for developing appropriate workflows and tracking all aspects related to the lifecycle of a claim by performing routine assessment of SOP compliance, audits of claims, and in-depth analysis of trends in denials, claims management, etc.
• Establishes an ongoing working relationship with other departments that impact revenue cycle performance.
• Works closely with various RCM vendors and teams (Eligibility, Prior Authorization, Claims Management, AR/Denial Management, and Patient Billing) to oversee operational activity that directly impacts the revenue cycle.
• Accurately process actions in a timely manner for optimal reimbursement.
• Track outcomes of payment resolution, appeals, and negotiated claims to ensure goals are met.
• Collect data metrics on revenue cycle tools and develop processes focused on these tools, including but not limited to: consents, protocols, SOPs.
• Create systems, patient and payer materials related to revenue cycle management.

Qualifications

• 7-10 years of revenue cycle experience, relevant work experience, and/or a Master’s degree in Healthcare Administration or Analytics.
• Experience working in biotech or laboratory billing is strongly preferred.
• Extensive knowledge of government and commercial insurance reimbursement policies, prior authorizations, and eligibility requirements.
• Extensive knowledge of reimbursement, billing, coding, and compliance regulations is required.

Additional Information

• This role works with PHI on a regular basis both in paper and electronic form and will have access to various technologies that provide access to PHI (paper and electronic) in order to perform the job.
• Employee must complete training relating to HIPAA/PHI privacy, General Policies and Procedure Compliance training, and security training as soon as possible but not later than the first 30 days of hire.
• Must maintain a current status on Natera training requirements.
• Performs other duties as assigned.