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Natera logo
Natera

Founded in 2004 and led by CEO Steve Chapman, Natera is a company in the biotechnology market that offers genetic testing and diagnostics on a global scale. Ope

Associate Director, Revenue Cycle – Prior Authorization

Location

United States

Posted

76 days ago

Salary

$130K - $170K / year

Seniority

Senior

Bachelor Degree8 yrs expEnglish

Job Description

Associate Director, Revenue Cycle – Prior Authorization

Natera

• Directs Billing Management and staff to ensure that authorizations, accurate submission of all claims and timely collections occurs in accordance with all third-party contract terms including, Medicare, Medical, managed care, commercial insurance, and direct patient pay. • Establishes and maintains all billing and financial data, including medical billing code tables, rate schedules and payer information. • Analyzes reimbursement from all sources, including carrier reimbursement exception reporting and follow up pending claims analysis and denials management. • Assures maximization of cash collections through diligent and timely monitoring of all authorizations and open accounts receivable balances. • Maintains and enhances billing policies and procedures for each function in the revenue cycle process and ensures staff adherence to policies. • Prepares detailed analyses and reports of prior authorizations, billing, accounts receivable activity and results, including performance matrixes, bad debt expense and AR days outstanding. • Manages for continuous improvements within the prior authorizations and revenue cycle process. • Effectively interacts with various functional areas and provides mentoring, coaching and performance reviews for direct reports. • Manages all outreach billing operations, including hiring, orientation, training, development, coaching, corrective actions, and ongoing monitoring of all staff work-related activities. • Ensures consistent quality of the billing services by distributing and assigning duties and responsibilities to employees, ensuring skill levels are appropriate to the assigned tasks, and monitoring the department’s productivity. • Leads a high performance team responsible for Prior Authorization Billing Operations. • Provides leadership, drives change, and facilitates process improvements. • Actively collaborates with the RCM (Billing) Finance team on analysis of billing activity for monthly financial reporting, the sales and marketing team of new and existing clients, and senior management on performance and new initiatives. • Participates in the Compliance Committee for Coding and Billing related items; establishes and enforces departmental and company policies and procedures. • Develops and monitors operating procedures and, where necessary, implements changes in workflow to improve productivity. • Drafts accurate budgeting and forecasting of headcount and cash receipts.

Job Requirements

  • Bachelor’s Degree in related field or equivalent years of relevant experience required.
  • Minimum of 8 years of experience in managing a high volume, fast growing billing office within the laboratory setting is preferred.
  • Extensive Prior Authorization billing operations experience.
  • Extensive knowledge of reimbursement, billing, coding and compliance regulations is required.
  • Experience with data analysis, reporting and relevant tools, such as Excel and PowerBI is required.

Benefits

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

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