Revenue Cycle Auditor

Salary: $65,000 - $85,000 USD Location Type: San Carlos, CA Employment Type: [Not Specified]

Position Overview

We are seeking a sharp, proactive, and technically adept Revenue Cycle Auditor to execute audit and process improvement initiatives across all revenue cycle functions. This role is critical in monitoring the production and performance of revenue cycle teams, identifying breakdowns in processes, tracking payer behavior trends, and identifying automation issues that impact performance and revenue. The ideal candidate will bring a blend of deep RCM expertise, strong technical acumen, and a root-cause analysis mindset to proactively identify and solve operational inefficiencies.

Key Responsibilities

• Conduct in-depth audits of production workflows, claims, Jira tickets, and system configurations to pinpoint gaps, breakdowns, or failures to meet KPIs.
• Follow audit pathways and methodologies across the revenue cycle, particularly around authorizations and claim life cycles.
• Identify root causes of denials or incorrect coding/configuration, and assess SOP/job aid adherence (“Was this workflow followed correctly?”).
• Collaborate cross-functionally with billing strategy, rev cycle leadership, operations, and tech teams to improve approvals and payments.
• Drive improvements in system design and automation effectiveness by testing changes before and after implementation to confirm the people, process, and system is doing what it’s supposed to.
• Perform technical audits of system-generated changes, such as coding automation or Jira ticket outcomes, ensuring configurations align with intent.
• Analyze large datasets to validate coding and automation accuracy, with focus on “Verification of Benefits” and payer requirement compliance.
• Review and refer to dashboards and audit reports using Power BI, SQL, and Snowflake to deliver data-driven insights to stakeholders.

Required Qualifications

• Bachelor’s degree in Business, Health Informatics, Data Science, or a related field preferred; equivalent years of relevant professional experience will be considered.
• 5+ years of experience in healthcare revenue cycle, with a focus on prior authorizations, claims auditing, and payer behavior analysis.
• Hands-on experience in lab billing strongly preferred.
• Familiarity with systems such as Xifin, Epic, Meditech, Salesforce, LIMs, and Waystar.
• Strong understanding of coding, reimbursement practices, and payer policy interpretation.
• Ability to work independently in a fast-paced, data-heavy environment and “deep dive” into issues with minimal oversight.
• Excellent communication and documentation skills, including the ability to present insights to operational and leadership teams.

Preferred Attributes

• Creative thinker and problem solver with an eye for identifying inefficiencies and optimizing workflows.
• Ability to:
  • Write SQL queries
  • Investigate Jira ticket history
  • Analyze configuration logs
• Curious and proactive—able to investigate complex systems and uncover latent issues.
• Not afraid to ask tough questions, dig for the ‘why,’ or challenge bad logic.
• Proven ability to build effective working relationships across technical, clinical, and operations teams.
• Experience working with offshore teams is a plus.
• Experience with automation testing and AI/LLM integrations (a bonus, not required).

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Company Information

Natera™ is a global leader in cell-free DNA (cfDNA) testing, dedicated to oncology, women’s health, and organ health. Our aim is to make personalized genetic testing and diagnostics part of the standard of care to protect health and enable earlier and more targeted interventions that lead to longer, healthier lives.