Billing Strategy Lead, Eligibility & Reimbursement

Summary

Join Natera as a Senior Billing Strategy Lead, a key subject matter expert driving strategic billing initiatives and leading cross-functional problem-solving related to payer coverage, claims processing, and insurance eligibility, particularly in lab services. This highly visible role involves close collaboration with executive leadership to achieve goals and implement data-driven solutions that improve reimbursement accuracy, billing efficiency, and payer compliance. The ideal candidate possesses extensive experience in revenue cycle management (RCM), laboratory billing, and payer coverage strategy, thriving in demanding environments and resolving complex challenges. Responsibilities include leading strategic initiatives focused on payer coverage analysis, reimbursement optimization, and denial mitigation; serving as an SME in RCM, insurance eligibility, and claims lifecycle; and partnering with executive leadership to define strategic goals and drive implementation. The role also requires leveraging business intelligence tools and healthcare platforms to extract insights and optimize billing workflows. Finally, the successful candidate will ensure regulatory compliance and deliver executive-level presentations.

Requirements

• 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

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

Preferred Qualifications

• 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

Benefits

• Employee benefits include comprehensive medical, dental, vision, life and disability plans for eligible employees and their dependents
• 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!