Associate Revenue Cycle Analyst, Prior Authorizations

Summary

Join Natera as an Associate Revenue Cycle Analyst, Prior Authorizations, where you will analyze medical claims, resolve payment issues, and negotiate with payers. You will develop and implement processes for dispute resolution and monitor key metrics. This role requires collaboration with various departments and vendors to optimize reimbursement. You will lead meetings, analyze trends, and support the organization's strategic goals. The position demands strong analytical, communication, and problem-solving skills. Natera offers competitive benefits, including comprehensive medical, dental, vision, life, and disability insurance, as well as paid time off and 401k benefits.

Requirements

• Bachelor's Degree in business or healthcare related field of study
• At least 2-3 years of experience in medical billing and Insurance collections
• Basic knowledge of CPT/HCPCS. ICD-10, modifier selection, and UB revenue codes
• 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 solve problems using critical thinking skills
• Maintain confidentiality of sensitive information
• Analytical skills
• Ability to think critically and identify the impact across the revenue cycle with a solution oriented approach
• Ability to develop, implement and produce analysis and reports

Responsibilities

• Serve as a source of knowledge for the designated revenue cycle function
• Perform analysis, identify trends, present opportunity areas, and prioritize initiatives for performance improvement for the designated revenue cycle function
• Assist with developing appropriate workflows and tracking for the designated revenue cycle function
• Establish an ongoing working relationship with other departments impacting revenue cycle performance
• Work 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
• Track outcomes of payment resolution, appeals, and negotiated claims to ensure goals are met
• Lead weekly meetings to review key metrics, workflows, trends, and performance improvement opportunities
• By continually reviewing and monitoring billing and coding changes, research, evaluate, and interpret guidance from a variety of sources to determine departmental actions
• Coordinate with Management to ensure thorough understanding of trends/issues affecting revenue cycle performance
• Support goals and metrics to link department and revenue cycle initiatives with the organization's strategy
• Develop, manage and monitor successful completion of implementation and project plans
• Act 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

Benefits

• Comprehensive medical, dental, vision, life and disability plans for eligible employees and their dependents
• Free testing for employees and their immediate families
• Fertility care benefits
• Pregnancy and baby bonding leave
• 401k benefits
• Commuter benefits
• Generous employee referral program