Manager, Denials and Appeals

US Remote

Job Title: Manager, Denials and Appeals

Company Overview:

Natera, Inc. is a global leader in cell-free DNA (cfDNA) testing, specializing in oncology, women's health, and organ health. Founded in 2004 and headquartered in Austin, Texas, Natera is dedicated to making personalized genetic testing and diagnostics a standard of care, enabling earlier and more targeted interventions to improve patient outcomes. With over 250 peer-reviewed publications and more than 10 million tests processed in CAP/CLIA-certified labs, Natera continues to advance molecular diagnostics with scientific rigor and integrity. (natera.com)

Job Summary:

We are seeking an experienced and strategic Manager, Denials and Appeals to oversee the denials management and appeals function within our Insurance Billing department. This role will be responsible for ensuring effective denials resolution, reimbursement optimization, and compliance with payer policies. The ideal candidate will lead a team of specialists, collaborate with cross-functional departments, and drive process improvements to enhance revenue cycle performance.

Key Responsibilities:

  • Lead and manage the denials and appeals team, ensuring efficiency, accuracy, and compliance in all aspects of the revenue cycle.
  • Oversee daily operations of denials management, including billing, eligibility verification, collections, and appeals processes.
  • Supervise and provide ongoing training for staff, ensuring they stay updated on payer policies, reimbursement trends, and best practices.
  • Develop and implement strategic initiatives to reduce denials, improve collections, and optimize reimbursement processes.
  • Analyze payer reimbursement patterns, identifying trends, risks, and opportunities for improvement.
  • Serve as a liaison between internal departments, ensuring clear communication and collaboration on revenue cycle projects.
  • Ensure timely, accurate submission and collection of all claims, proactively identifying and resolving issues that impact reimbursement.
  • Collaborate with insurance verification, billing, and collections teams to streamline workflows and enhance operational efficiency.
  • Monitor and validate adherence to company policies, compliance regulations, and payer guidelines, conducting audits as necessary.
  • Track KPIs and performance metrics, providing insights and recommendations to senior leadership to improve revenue cycle outcomes.
  • Build and maintain positive team culture, fostering engagement, motivation, and professional growth.
  • Maintain strict confidentiality and compliance with Protected Health Information (PHI) regulations, ensuring secure handling of sensitive data.

 

#LI-AB1

Skills and Qualifications:

  • Bachelor’s degree in a related field or equivalent experience required.
  • 5+ years of experience managing a high-volume, fast-paced billing office, preferably within a laboratory or healthcare setting.
  • Strong knowledge of medical billing, denials management, appeals processes, reimbursement methodologies, and payer compliance regulations.
  • Experience leading large teams, with a focus on coaching, training, and performance management.
  • Proficiency in billing systems, revenue cycle management tools, and data analysis platforms.
  • Strong problem-solving, analytical, and organizational skills with the ability to manage multiple projects simultaneously.
  • Excellent communication and leadership skills, with the ability to collaborate effectively across departments.
  • Knowledge of insurance verification, coding regulations, and payer contract analysis.
  • Ability to adapt to a fast-growing environment and drive continuous improvement initiatives.

If you are a results-driven leader with a passion for revenue cycle optimization and denials management, we encourage you to apply and be part of our dynamic team at Natera!

The pay range is listed and actual compensation packages are based on a wide array of factors unique to each candidate, including but not limited to skill set, years & depth of experience, certifications and specific office location. This may differ in other locations due to cost of labor considerations.

San Carlos, CA

$95,000 - $120,000 USD

OUR OPPORTUNITY

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.

The Natera team consists of highly dedicated statisticians, geneticists, doctors, laboratory scientists, business professionals, software engineers and many other professionals from world-class institutions, who care deeply for our work and each other. When you join Natera, you’ll work hard and grow quickly. Working alongside the elite of the industry, you’ll be stretched and challenged, and take pride in being part of a company that is changing the landscape of genetic disease management.

WHAT WE OFFER

Competitive Benefits - Employee benefits include comprehensive medical, dental, vision, life and disability plans for eligible employees and their dependents. Additionally, Natera employees and their immediate families receive free testing in addition to fertility care benefits. Other benefits include pregnancy and baby bonding leave, 401k benefits, commuter benefits and much more. We also offer a generous employee referral program!

For more information, visit www.natera.com.

Natera is proud to be an Equal Opportunity Employer. We are committed to ensuring a diverse and inclusive workplace environment, and welcome people of different backgrounds, experiences, abilities and perspectives. Inclusive collaboration benefits our employees, our community and our patients, and is critical to our mission of changing the management of disease worldwide.

All qualified applicants are encouraged to apply, and will be considered without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, age, veteran status, disability or any other legally protected status. We also consider qualified applicants regardless of criminal histories, consistent with applicable laws.

If you are based in California, we encourage you to read this important information for California residents. 

Link: https://www.natera.com/notice-of-data-collection-california-residents/

Please be advised that Natera will reach out to candidates with a @natera.com email domain ONLY. Email communications from all other domain names are not from Natera or its employees and are fraudulent. Natera does not request interviews via text messages and does not ask for personal information until a candidate has engaged with the company and has spoken to a recruiter and the hiring team. Natera takes cyber crimes seriously, and will collaborate with law enforcement authorities to prosecute any related cyber crimes.

For more information:
- BBB announcement on job scams 
- FBI Cyber Crime resource page 

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