Revenue Cycle Auditor

Summary

Join Natera as a Revenue Cycle Auditor to conduct audits, identify process improvements, and analyze data to enhance revenue cycle performance. You will investigate and resolve operational inefficiencies, collaborating with cross-functional teams. The ideal candidate possesses strong RCM expertise, technical skills, and a root-cause analysis mindset. Responsibilities include auditing workflows, claims, and systems, identifying denial root causes, and improving system design and automation. Data analysis using Power BI, SQL, and Snowflake is crucial. This role requires a Bachelor’s degree or equivalent experience and 5+ years in healthcare revenue cycle.

Requirements

• Bachelor’s degree in Business, Health Informatics, Data Science, or a related field preferred; equivalent years of relevant professional experience will be considered
• 5+ years of experience in healthcare revenue cycle, with a focus on prior authorizations, claims auditing, and payer behavior analysis
• Familiarity with systems such as Xifin, Epic, Meditech, Salesforce, LIMs, and Waystar
• Strong understanding of coding, reimbursement practices, and payer policy interpretation
• Ability to work independently in a fast-paced, data-heavy environment and “deep dive” into issues with minimal oversight
• Excellent communication and documentation skills, including the ability to present insights to operational and leadership teams

Responsibilities

• Conduct in-depth audits of production workflows, claims, Jira tickets, and system configurations to pinpoint gaps, breakdowns, or failures to meet KPIs
• Follow audit pathways and methodologies across the revenue cycle, particularly around authorizations and claim life cycles
• Identify root causes of denials or incorrect coding/configuration, and assess SOP/job aid adherence (“Was this workflow followed correctly?”)
• Collaborate cross-functionally with billing strategy, rev cycle leadership, operations, and tech teams to improve approvals and payments
• Drive improvements in system design and automation effectiveness by testing changes before and after implementation to confirm the people, process, and system is doing what it’s supposed to
• Perform technical audits of system-generated changes, such as coding automation or Jira ticket outcomes, ensuring configurations align with intent
• Analyze large datasets to validate coding and automation accuracy, with focus on “Verification of Benefits” and payer requirement compliance
• Review and refer to dashboards and audit reports using Power BI, SQL, and Snowflake to deliver data-driven insights to stakeholders

Preferred Qualifications

• Hands-on experience in lab billing strongly preferred
• Creative thinker and problem solver with an eye for identifying inefficiencies and optimizing workflows
• Ability to: Write SQL queries
• Investigate Jira ticket history
• Analyze configuration logs
• Curious and proactive—able to investigate complex systems and uncover latent issues
• Not afraid to ask tough questions, dig for the ‘why,’ or challenge bad logic
• Proven ability to build effective working relationships across technical, clinical, and operations teams
• Experience working with offshore teams is a plus
• Experience with automation testing and AI/LLM integrations (a bonus, not required)

Benefits

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