Associate Director, Clean Claims and Revenue Cycle Operations

Summary

Join Natera as an Associate Director and lead claim rejections, timely filing, unresponded claims, claims billing and submissions, and related accounts receivable management teams. You will manage billing staff, oversee relevant functions, and execute strategic goals. Responsibilities include directing billing management, establishing and maintaining billing data, analyzing reimbursements, maintaining billing policies, preparing reports, managing continuous improvements, interacting with various functional areas, managing staff, collaborating with cross-functional partners, participating in committees, developing operating procedures, creating performance standards, interfacing with payers, managing vendors, preparing performance evaluations, and identifying opportunities for automation. A Bachelor’s Degree and 8+ years of relevant experience are required. Extensive knowledge of reimbursement, billing, coding, and compliance regulations is also necessary. The position offers competitive benefits including comprehensive medical, dental, vision, life, and disability plans, free testing for employees and their families, fertility care benefits, pregnancy and baby bonding leave, 401k benefits, and more.

Requirements

• Bachelor’s Degree in related field or equivalent required
• Extensive knowledge of reimbursement, billing, coding and compliance regulations is required
• Demonstrated leadership ability in a multi-site environment
• Capacity to actively engage and communicate with a wide variety of employees, senior leaders and external auditors to drive change and problem solve
• Ability to respond to change quickly and generate creative ideas and solutions to emerging business changes
• Active, visible and influential leadership style such as ability to directly engage, arrive at conclusions, drive consensus, and monitor actions in support of quality outcomes
• Skilled in researching, interpreting, and presenting data in a concise manner
• Demonstrates strong ability to effectively plan, organize, and delegate
• Leads by example and demonstrates commitment to continual improvement and a passion for excellence
• Maintains a high standard of discipline, professionalism, and sound decision making for excellence. Ability to motivate a highly successful team to exceed performance goals, drive change, and lead a growing staff
• Personable, persuasive, and comfortable navigating all levels of the workforce
• Communication – Proficient verbal and written communication skills
• Willingness to share and receive information and ideas from all levels of the organization in order to achieve the desired results
• Teamwork – Commitment to the successful achievement of team and organizational goals through a desire to participate with and help other members of the team
• Customer Service Focus – Demonstrate a focus on listening to and understanding client/customer needs and then delighting the client/customer by exceeding service and quality expectations

Responsibilities

• Directs Billing Management and staff to ensure that accurate submission of all claims and timely collections occurs in accordance with all third party contract terms including, Medicare, Medical, managed care, commercial insurance, and direct patient pay
• Establishes and maintains all billing and financial data, including medical billing code tables, rate schedules and payer information
• Analyzes reimbursement from all sources, including carrier reimbursement exception reporting and follow up pending claims analysis and denials management
• Maintains and enhance billing policies and procedures for each function in the revenue cycle process and ensure staff adherence to policies
• Prepares detailed analyses and reports of billing and accounts receivable activity and results, including performance matrixes
• Manages for continuous improvements within the revenue cycle process
• Effectively interacts with various functional areas, provides mentoring, coaching and performance reviews for direct reports
• Manages all hiring, orientation, training, development, coaching, corrective actions, and ongoing monitoring of all staff work-related activities
• Ensures consistent quality of the billing services by distributing and assigning duties and responsibilities to employees, ensuring skill levels are appropriate to the assigned tasks, and monitoring the department’s productivity
• Actively collaborates with the cross functional partners such as Billing Strategy, Payor Relations, Systems Configuration, and others on analysis of billing activity for monthly financial reporting, the sales and marketing team of new and existing clients, and senior management on performance and new initiatives
• Participates in the various Committees for Billing related items; establishes and enforces departmental and company policies and procedures
• Develops and monitors operating procedures and, where necessary, implements changes in workflow to improve productivity. Drafts accurate budgeting and forecasting of headcount
• Creates and holds billing leadership accountable for established performance and production standards. Maintains billing related quality patient outcomes
• Interfaces with third party payers to resolve reimbursement issues and provides guidance to appropriate senior leadership regarding contracting challenges
• Manages, interacts with, influences, and manages the performance of offshore and onshore vendors and vendor partners
• Prepares annual performance evaluations and recommends merit increase and bonus percentages. Promotes organizational efficiency, needed change and continuous quality improvement
• Identifies and implements opportunities for automation and improved efficiency
• Assists as needed to perform other related duties and special projects as required

Preferred Qualifications

Minimum of 8 years of experience in managing a high volume, fast growing billing office within the laboratory setting is preferred (staff of 50-100)

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!