Claims Management Analyst

Summary

Join Natera as a Claims Management Analyst and oversee the follow-up and resolution of insurance claims. You will serve as the primary point of contact for internal and external partners, driving performance improvements in claim correction and resubmission. This leadership role involves identifying trends, managing high-priority accounts, and supporting the organization’s financial objectives. Analyze claim management trends, ensure efficient workflows, and build strong relationships with internal and external stakeholders. You will also monitor key performance indicators, lead team meetings, audit payer contracts, and develop strategies to enhance claim management. The position requires active participation in claim resolution and project management.

Requirements

• Bachelor’s degree in Business, Healthcare Administration, or a related field; or equivalent combination of education and experience
• Minimum 4–6 years of experience in medical billing, insurance follow-up, or claims resolution roles
• In-depth understanding of end to end insurance claims processing workflows
• Willingness to actively engage in hands-on claim resolution work when necessary to meet department goals and support team workload
• Proficiency in medical billing systems
• Intermediate skills in Microsoft Excel (pivot tables, VLOOKUPs)
• Working knowledge of medical terminology and procedure codes
• Excellent communication skills – both verbal and written
• Strong organizational and time management skills; ability to manage multiple priorities
• Analytical mindset with the ability to identify trends and propose solutions
• Ability to solve complex problems independently and exercise critical thinking
• Ability to maintain confidentiality of sensitive patient and business information
• 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

Responsibilities

• Serve as the subject matter expert on rejections, providing support, oversight, and leadership on related processes and systems
• Analyze trends and patterns in claim management to identify root causes and process improvement opportunities
• Ensure claims workflows and follow-up processes are appropriately configured to correct and resubmit rejected claims in a timely and accurate manner
• Build and maintain strong working relationships with internal departments and external vendors to enhance claims management effectiveness
• Oversee day-to-day rejection follow-up activities to ensure timely corrections, resubmissions, and escalation of aging or high-priority rejections
• Monitor key performance indicators and claim resolution metrics; ensure departmental goals related to claims are met
• Lead weekly team meetings to review claims management metrics, workflow challenges, and improvement initiatives
• Audit payer contracts, service setups, and configuration changes to ensure proper alignment with claim management procedures
• Coordinate with leadership to communicate rejection trends, denial patterns, payer issues, and process updates
• Develop goals and performance indicators that align claim management efforts with broader organizational strategy
• Manage and monitor project plans related to claim resolution initiatives and ensure successful execution
• Act as an educator to team members and stakeholders regarding best practices and improvement strategies for handling claims management
• Identify and recommend tools or technologies to enhance claim tracking, rejection resolution, and reporting
• Lead resolution of escalated, high-value, or problematic rejections and develop action plans to address recurring payer challenges
• Actively participate in day-to-day claim follow-up work as needed to support team performance and ensure timely resolution of rejected claims

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!