Manager, Revenue Cycle Audits

Summary

Join Natera as a Revenue Cycle Audit Manager and build, maintain, and lead personnel audits across the organization and with external billing providers. You will manage revenue cycle audit projects, focusing on personnel training, productivity, and accuracy to enhance reimbursement performance. This role involves directing and overseeing processes impacting cash collections and reporting to senior management. Responsibilities include performing audits and analysis, building auditing templates, monitoring team performance, and serving as a knowledge resource. You will also manage a team of auditors, improve processes based on audit findings, and collaborate with various departments and vendors. Finally, you will lead meetings, coordinate with management, and develop performance goals and metrics.

Requirements

• Bachelor’s degree in Accounting, Business, Healthcare related field, or equivalent experience
• Minimum of 6-8 years of related experience in medical billing and/or insurance collections, including at least 3 years of experience with prior authorization requirements, AR & Denial management, payer utilization management policies, and appeals
• Certified in coding or similar coding management experience
• Management experience is required
• Proficiency with medical billing systems, Microsoft Excel, medical terminology, and basic procedure coding knowledge
• Knowledge of medical terminology and abbreviations, and healthcare nomenclature and systems
• 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
• Strong communication skills
• Demonstrated ability to work independently and collaborate with team members
• Motivated to be creative and brainstorm innovative solutions
• A desire to work for a dynamic and growing molecular genetics laboratory and manage growth for optimal success

Responsibilities

• Perform audits and analysis, identify trends, present opportunity areas, and prioritize initiatives for performance improvement for the revenue cycle team
• Build auditing templates with an effective scoring methodology to monitor RCM team performance in areas such as billing, coding, denial management, and patient billing
• Monitor and manage targets for personnel SLAs with internal and external teams via audits
• Serve as a source of knowledge for the revenue cycle team
• Manage a team of auditors including hiring, training, and setting processes for personnel audits
• Track outcomes of personnel audits and training to ensure audit feedback is effective
• Responsible for modifying workflows, SOPs, and SLA tracking for the designated revenue cycle function based on audit findings
• Work with other teams/departments to streamline and strengthen processes, including billing automation
• Establish an ongoing working relationship with other departments and external vendors impacting revenue cycle performance
• Work closely with various vendor operations teams (Prior Authorization, Claims, and Appeals) to oversee personnel activity that directly impacts the revenue cycle for optimal reimbursement
• Lead weekly meetings to review key metrics, workflows, trends, and performance improvement opportunities and provide detailed status reports to management
• Coordinate with management to ensure a thorough understanding of trends/issues affecting revenue cycle performance
• Develop performance 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

Preferred Qualifications

Lab & Diagnostic industry-based RCM experience would be a plus

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!