Revenue Cycle Auditor

United States

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Not SpecifiedCompensation

Mid-level (3 to 4 years), Senior (5 to 8 years)Experience Level

Full TimeJob Type

UnknownVisa

Healthcare, Revenue Cycle ManagementIndustries

Requirements

Candidates should possess a Bachelor's degree in Business, Health Informatics, Data Science, or a related field, or equivalent professional experience. A minimum of 5 years of experience in healthcare revenue cycle, with a focus on prior authorizations, claims auditing, and payer behavior analysis, is required. Hands-on experience in lab billing and familiarity with systems like Xifin, Epic, Meditech, Salesforce, LIMs, and Waystar are strongly preferred. The role demands a strong understanding of coding, reimbursement practices, and payer policy interpretation, along with the ability to work independently in a fast-paced, data-heavy environment and perform deep dives into issues with minimal oversight. Excellent communication and documentation skills are essential.

Responsibilities

The Revenue Cycle Auditor will conduct in-depth audits of production workflows, claims, Jira tickets, and system configurations to identify gaps and failures. They will follow audit pathways across the revenue cycle, focusing on authorizations and claim life cycles, and identify root causes of denials or incorrect coding. Responsibilities include collaborating with cross-functional teams to improve approvals and payments, driving improvements in system design and automation effectiveness through testing, and performing technical audits of system-generated changes. The auditor will analyze large datasets to validate coding and automation accuracy, with a focus on Verification of Benefits and payer requirement compliance, and deliver data-driven insights using Power BI, SQL, and Snowflake.

Skills

Revenue Cycle Management

Auditing

Process Improvement

Root Cause Analysis

Data Analysis

Power BI

SQL

Snowflake

Verification of Benefits

Coding

Claim Life Cycle

Jira

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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