Manager, Denials Management

POSITION SUMMARY:

Effectively leads denials management within billing, collection or accounts receivable management, maintaining a full understanding of the billing information system. Manages the activities of staff through daily supervision while overseeing the denials management functional area across revenue cycle including but not limited to billing and eligibility functions. Assists with implementing strategic goals by deploying internal and external staff.

PRIMARY 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.

QUALIFICATIONS:

• Bachelor’s Degree in related field or equivalent required
• Minimum of 5 years of experience in managing a high-volume, fast-growing billing office within the laboratory setting is preferred.
• Extensive knowledge of reimbursement, billing, coding and compliance regulations is required

REQUIRED SKILLS, KNOWLEDGE AND ABILITIES: 

• Experience training in fields such as business administration, accountancy, sales, marketing, computer sciences or similar vocations.
• At least two (2) years of experience managing a team and working within insurance billing and denial management.
• Ability to perform complex analysis and discuss with upper management.
• Ability to communicate effectively both orally and in writing.
• Strong interpersonal skills as well as organizational skills, including attention to detail.
• Knowledge of payer eligibility and benefits.
• Experience in healthcare research and analysis skills, sufficient to support payer research healthcare policy library and state management.
• Ability to resolve associate issues effectively and efficiently.

 

#LI-REMOTE

 

The pay range is listed and actual compensation packages are based on a wide array of factors unique to each candidate, including but not limited to skill set, years & depth of experience, certifications and specific office location. This may differ in other locations due to cost of labor considerations.New York$100,000—$150,000 USD

OUR OPPORTUNITY

Natera™ is a global leader in cell-free DNA (cfDNA) testing, dedicated to oncology, women’s health, and organ health. Our aim is to make personalized genetic testing and diagnostics part of the standard of care to protect health and enable earlier and more targeted interventions that lead to longer, healthier lives.

The Natera team consists of highly dedicated statisticians, geneticists, doctors, laboratory scientists, business professionals, software engineers and many other professionals from world-class institutions, who care deeply for our work and each other. When you join Natera, you’ll work hard and grow quickly. Working alongside the elite of the industry, you’ll be stretched and challenged, and take pride in being part of a company that is changing the landscape of genetic disease management.

WHAT WE OFFER