Revenue Cycle Analyst - Denials & Appeals

About the role

The Revenue Cycle Analyst will be responsible for building and maintaining collaborative and productive relationships within the organization relating to Revenue Cycle Management, managing revenue cycle projects, driving performance in operations related to reimbursement and providing direction and oversight of processes impacting cash collections.

Job Responsibilities

• Serves as the primary source of knowledge for the designated revenue cycle function.
• Performs analysis, identifies trends, presents opportunity areas, and prioritizes initiatives for performance improvement for the designated revenue cycle function.
• Responsible for ensuring appropriate configuration of systems and workflows for designated revenue cycle function.
• Establishes an ongoing working relationship with other departments impacting revenue cycle performance.
• Works closely with the vendor operations teams to oversight operations activity that directly impact the revenue cycle to accurately process actions in a timely manner for optimal reimbursement.
• Tracks on-going performance of revenue cycle metrics and activities to ensure goals are met.
• Leads weekly meetings to review key metrics, workflows, trends, and performance improvement opportunities.
• By continually reviewing and monitoring billing and coding changes, researches, evaluates, and interprets guidance from a variety of sources to determine departmental actions.
• Coordinates with Management to ensure thorough understanding of trends/issues affecting revenue cycle performance.
• Develops goals and metrics to link department and revenue cycle initiatives with the organization's strategy.
• Develops, manages and monitors successful completion of implementation and project plans.
• Acts as an educator on performance improvement requirements in operations and methodologies to related teams and departments.
• Continuously seek new and creative technologies that help identify and guide improvement opportunities that align with overall company success.
• Responsible for ongoing denial trend research and analysis, including evaluation of clinical, coding and reimbursement policies, and translating that information into action plans that drive end-to-end performance improvement.

Qualifications

• Bachelor's Degree in business, analytics or healthcare related field of study, or equivalent years of relevant experience.
• At least 4-6 years of experience in medical billing and Insurance collections.
• Advanced knowledge of CPT/HCPCS. ICD-10, modifier selection, and UB revenue codes.

Required Knowledge, Skills and Abilities

• Proficiency with medical billing systems, Microsoft Excel, medical terminology and basic procedure coding knowledge.
• Knowledge of medical terminology and abbreviations, and health care nomenclature and systems.
• Strong communication (verbal and written), organizational, problem solving and team player skills.
• Ability to navigate across multiple customer demands and balance competing priorities successfully.
• Ability to analyze, identify and articulate identified trends and report trends succinctly in a clear and concise manner.
• Ability to independently solve complex problems using critical thinking skills.
• Maintains confidentiality of sensitive information.
• Analytical skills required.
• Ability to think critically and identify the global impact across the revenue cycle with a solution oriented approach.
• Ability to develop, implement and produce complex analysis and reports.
• Ability to motivate and create a team environment, prioritize work distribution, exceptional organizational and time management skills.
• Requires advanced project management skills, must be able to manage multiple projects.

Pay and benefits

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.

Remote USA $69,400 - $85,000 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!

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.

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

Link

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