Billing Strategy Lead, Eligibility & Reimbursement

The Senior Billing Strategy Lead at Natera is a key subject matter expert (SME) responsible for driving strategic billing initiatives and leading cross-functional problem-solving related to payer coverage, claims processing, and insurance eligibility—particularly in the lab services space. This role is highly visible, working closely with executive leadership to identify goals and execute data-driven solutions that enhance reimbursement accuracy, billing efficiency, and payer compliance.

We are looking for a hands-on expert with deep experience in revenue cycle management (RCM), laboratory billing, and payer coverage strategy. The ideal candidate thrives under high expectations, has strong business and technical acumen, and excels in navigating and resolving complex coverage and reimbursement challenges.

Primary Responsibilities

• Lead strategic initiatives focused on payer coverage analysis, reimbursement optimization, and denial mitigation—especially in scenarios where coverage is unclear or absent.
  
  
• Serve as an SME in RCM, insurance eligibility, and claims lifecycle, with a particular focus on laboratory workflows.
  
  
• Proactively identify gaps in payer contract compliance, missing or inaccurate insurance information, and design scalable solutions for upstream corrections.
  
  
• Conduct deep-dive investigations into coverage gaps, root cause analysis of claim denials, and eligibility rejections; translate findings into operational improvements.
  
  
• Partner with executive leadership to define strategic goals, develop project plans, and drive cross-functional implementation.
  
  
• Support project management across departments and contribute industry knowledge to ensure alignment on market trends, payer policies, and lab billing practices.
  
  
• Leverage business intelligence tools (Excel, Power BI, SQL, Snowflake) and healthcare platforms (AdvancedMD, EMRs, billing systems) to extract insights and enable informed decision-making.
  
  
• Identify and assess new technologies and open-source tools that can optimize billing workflows, eligibility verification, and payer interaction.
  
  
• Ensure consistent adherence to SOPs, SLAs, quality benchmarks, and regulatory compliance including HIPAA/PHI handling protocols.
  
  
• Provide leadership and oversight in the creation and rollout of Natera SOP documentation.
  
  
• Deliver polished executive-level presentations and performance updates with actionable insights.
  
  

Qualifications

• Bachelor’s Degree in Business, Healthcare Administration, Economics, Information Systems, or a related field; Master’s preferred.
  
  
• 8+ years of experience in healthcare billing, revenue cycle operations, or payer relations—with significant exposure to lab billing and payer eligibility workflows.
  
  
• Demonstrated ability to work under pressure and meet demanding executive expectations.
  
  
• Proven success as an independent problem-solver and strategic thinker in a fast-paced, evolving environment.
  
  
• Strong understanding of payer contracts, prior authorization requirements, claim adjudication, and insurance eligibility verification.
  
  
• Hands-on experience with SQL, Snowflake, and familiarity with healthcare platforms including AdvancedMD, EMRs, and payer portals.
  
  
• Experience with BI tools such as Power BI, Hyperion, or Business Objects.
  
  
• Ability to synthesize and communicate complex data insights clearly and effectively to varied audiences, including senior executives.
  
  
• Excellent interpersonal skills and a collaborative, consultative working style.
  
  

Key Attributes

• Deep knowledge of RCM strategy, claims workflows, and insurance operations in the lab environment.
  
  
• Innovative and analytical mindset, driven to identify root causes and deliver sustainable solutions.
  
  
• High accountability, adaptability, and a proactive approach to solving coverage and reimbursement challenges.
  
  
• Confident decision-maker with a track record of guiding teams and stakeholders toward operational excellence.
  
  
• Strong communicator and influencer who can translate business problems into technical solutions.

#LI-AB1

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