Director, Revenue Cycle Billing Strategy

POSITION SUMMARY:

The Director of Billing Strategy plays a key role in leading strategic improvements within the revenue cycle processes in Natera. This role will oversee Natera's product(s) reimbursement and revenue cycle operations that impact the financial performance of the product(s). They are expected to work across departments to integrate RCM knowledge and expertise with process improvements, data analysis and strategic initiatives. 

PRIMARY RESPONSIBILITIES:

• Manages revenue cycle projects related to specific products by identifying opportunities for process improvement
• Redesign processes and documentation of SOPs, implementation of new workflows and monitoring of operational metrics.
• Serves as a source of subject matter expertise and performs analysis, identifies trends, presents solutions and insights, and prioritizes initiatives for process and performance improvement.
• Responsible for developing appropriate workflows and tracking all aspects related to the lifecycle of a claim by performing routine assessment of SOP compliance, audits of claims and/or in-depth analysis of trends in denials, claims management etc.
• Establishes an ongoing working relationship with other departments that impact revenue cycle performance.
• Works closely with various RCM vendors and teams (Eligibility, Prior Authorization, Claims Management, AR/Denial Management and Patient Billing) to oversee operational activity that directly impacts the revenue cycle.
• Accurately process actions in a timely manner for optimal reimbursement.
• Track outcomes of payment resolution, appeals, and negotiated claims to ensure goals are met.
• Collect data metrics on revenue cycle tools and develop processes focused on these tools, including but not limited to: consents, protocols, SOPs
• Tracks outcomes of payment resolution, appeals, and negotiated claims to ensure goals are met.
• Create systems, patient and payer materials related to revenue cycle management.
• This role works with PHI on a regular basis both in paper and electronic form and will have access to various technologies that provide access to PHI (paper and electronic) in order to perform the job.
• Employee must complete training relating to HIPAA/PHI privacy, General Policies and Procedure Compliance training and security training as soon as possible but not later than the first 30 days of hire.
• Must maintain a current status on Natera training requirements.
• Performs other duties as assigned.

QUALIFICATIONS:

• 7- 10 years of revenue cycle experience, relevant work experience and/or Master’s degree in Healthcare Administration or Analytics. 
• Experience working in biotech or laboratory billing is strongly preferred.
• Extensive knowledge of government and commercial insurance reimbursement policies, prior authorizations, and eligibility requirements.
• Extensive knowledge of reimbursement, billing, coding and compliance regulations is required. 
• Experience with data analysis, data interpretation and analytics, specifically with PowerBI, Google Suite and Excel

KNOWLEDGE, SKILLS, AND ABILITIES:

• Exceptional communication skills (oral and written) and attention to detail
• 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 company and manage growth for optimal success
• Capacity to actively engage and communicate with a wide variety of employees, senior leaders and external auditors to drive change and problem solve.
• Ability to respond to change quickly and generate creative ideas and solutions to emerging business changes.
• Proactive and self-driven in nature, and able to work in a fast-paced environment with minimal structure. 
• Skilled in researching, interpreting, and presenting data in a concise manner.

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