Manager, Denials and Appeals

Summary

Join Natera's Insurance Billing department as a Manager, Denials and Appeals, leading a team focused on collection and accounts receivable management. You will supervise staff, oversee denials management across the revenue cycle, and assist in implementing strategic goals. Responsibilities include analyzing reimbursements, ensuring timely claim submissions, and collaborating with internal departments. The role requires a Bachelor's degree or equivalent experience, extensive knowledge of billing and compliance, and strong leadership and analytical skills. Natera offers competitive benefits, including comprehensive medical, dental, vision, life, and disability plans, as well as free testing for employees and their families.

Requirements

• Bachelor’s Degree in related field or equivalent years of experience required
• Extensive knowledge of reimbursement, billing, coding and compliance regulations is required

Responsibilities

• Experience with managing large teams, including supervision of staff of a denials management department
• Experience with directing self and others in areas of responsibility such as research, appeals and payment posting
• Assists with feedback for hiring, discipline and performance evaluations
• Provides department orientation and ongoing training for all in/direct reports
• Liaison with internal departments to promote ongoing communication, and collaboration on cross functional projects related to denials management
• Analyzes reimbursement from all sources, including carrier reimbursement exception reporting and follow up pending claims analysis and denials management
• Represent organizational projects and assist management with follow-through and implementation of initiatives
• Manage all aspects of the denials management department including the timely, accurate submission and collection of all patient and customer accounts
• Works with across departments to manage the entire process from insurance verification to final collection
• Responsible for the timely accurate submission of all claims for service to the responsible payer
• Ensure that all payers are set up correctly within the software system
• Monitors and validates adherence to Policies and Procedures, auditing as necessary. Monitors and evaluates employee productivity and performance to goal
• Builds employee morale, motivation and loyalty by fostering positive working relationships
• This role works with PHI on a regular basis both in paper and electronic form and has access to various technologies to access PHI (paper and electronic) in order to perform the job

Preferred Qualifications

• Minimum of 5 years of experience in managing a high-volume, fast-growing billing office within the laboratory setting is preferred
• Training in fields such as business administration, healthcare billing, accountancy, or similar vocations
• A minimum of two (4) years of directly related and progressively responsible experience
• Ability to perform complex analysis and discuss with upper management
• Skilled in Microsoft Office: Word and Excel
• Ability to communicate effectively both orally and in writing
• Strong interpersonal skills
• Strong organizational skills, including attention to detail
• Knowledge of payer eligibility and benefits
• Health care research and analysis skills sufficient to support payer research through healthcare policy library and state management
• Ability to resolve associate issues effectively and efficiently

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!