Revenue Cycle Claims Client Billing Specialist

Summary

Join Natera as a Revenue Cycle Claims Specialist and build strong relationships within the organization to manage revenue cycle projects and drive performance in reimbursement. You will analyze data, identify trends, and prioritize initiatives for improvement. Responsibilities include developing workflows, collaborating with vendors, tracking payment outcomes, leading meetings, and researching billing and coding changes. You will also coordinate with management, develop goals and metrics, manage project plans, and act as an educator on performance improvement. This role requires at least 3 years of experience in medical billing and insurance collections, along with knowledge of CPT/HCPCS, ICD-10, and UB revenue codes. The position offers a competitive salary and benefits package.

Requirements

• Have at least 3 years of experience in medical billing and Insurance collections
• Have at least 3 years of experience with Prior Authorization requirements, payer utilization management policies and Appeals
• Possess knowledge of CPT/HCPCS. ICD-10, modifier selection and UB revenue codes
• Have a Healthcare related field of study or equivalent experience
• Be proficient with medical billing systems, Microsoft Excel, medical terminology and basic procedure coding knowledge
• Possess knowledge of medical terminology and abbreviations, and health care nomenclature and systems
• Have strong communication (verbal and written), organizational, problem solving and team player skills
• Be able to navigate across multiple customer demands and balance competing priorities successfully
• Be able to analyze, identify and articulate identified trends and report trends succinctly in a clear and concise manner
• Be able to solve problems using critical thinking skills
• Maintain confidentiality of sensitive information
• Possess analytical skills
• Be able to think critically and identify the impact across the revenue cycle with a solution oriented approach
• Be able to develop, implement and produce analysis and reports

Responsibilities

• Serve as a source of knowledge for the designated revenue cycle function
• Perform analysis, identify trends, present opportunity areas, and prioritize initiatives for performance improvement for the designated revenue cycle function
• Be responsible for developing appropriate workflows and tracking for the designated revenue cycle function
• Establish an ongoing working relationship with other departments impacting revenue cycle performance
• Work closely with various vendor operations teams (Prior authorization, Claims and Appeals) to oversee operations activity that directly impacts the revenue cycle to accurately process actions in a timely manner for optimal reimbursement
• Track outcomes of payment resolution, appeals, and negotiated claims to ensure goals are met
• Lead weekly meetings to review key metrics, workflows, trends, and performance improvement opportunities
• By continually reviewing and monitoring billing and coding changes, research, evaluate, and interpret guidance from a variety of sources to determine departmental actions
• Coordinate with Management to ensure thorough understanding of trends/issues affecting revenue cycle performance
• Develop 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
• Act as an educator on performance improvement requirements in operations and methodologies to related teams and departments
• Continuously seek new and creative technologies that help identify and guide improvement opportunities that align with overall company success

Benefits

• Comprehensive medical, dental, vision, life and disability plans for eligible employees and their dependents
• Free testing for employees and their immediate families
• Fertility care benefits
• Pregnancy and baby bonding leave
• 401k benefits
• Commuter benefits
• Generous employee referral program