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Manager, Revenue Cycle Audits

Natera

Natera

Remote
Posted on Thursday, May 23, 2024

Position Summary:

The Revenue Cycle Audit Manager will be responsible for building and maintaining collaborative and productive personnel audits within the organization and with the outsourced billing providers related to Revenue Cycle Management. This role will manage revenue cycle audit projects related to personnel training, productivity, and accuracy to drive performance in operations related to reimbursement and provide direction and oversight of processes impacting cash collections. This role will be reporting to the Senior Director of Billing and Clinical Information Management Strategy and/or the Associate Director of the Revenue Cycle Audit Team.

Job Responsibilities:

  • Performs audits and analysis, identifies trends, presents opportunity areas, and prioritizes initiatives for performance improvement for the revenue cycle team.

  • Build Auditing templates with a scoring methodology that is effective to monitor RCM team performance in areas of billing, coding, denial management and patient billing.

  • Monitors and manages target for personnel SLAs with internal and external teams via audits

  • Serves as a source of knowledge for the revenue cycle team.

  • Manage a team of auditors including hiring, training, setting processes for personnel audits

  • Responsible for modifying workflows, SOPs and SLA tracking for the designated revenue cycle function based on audit findings

  • Establishes an ongoing working relationship with other departments and external vendors impacting revenue cycle performance.

  • Works closely with various vendor operations teams (Prior authorization, Claims and Appeals) to oversee personnel activity that directly impacts the revenue cycle to accurately process actions in a timely manner for optimal reimbursement.

  • Tracks outcomes of personnel audits and training to ensure audit feedback is effective.

  • Leads weekly meetings to review key metrics, workflows, trends, and performance improvement opportunities and provides detailed status reports to management.

  • Coordinates with Management to ensure thorough understanding of trends/issues affecting revenue cycle performance.

  • Develops performance goals and metrics to link department and revenue cycle initiatives with the organization's strategy.

  • Develops, manages, and monitors successful completion of implementation and project plans.

  • Works with other Teams/Departments to streamline and strengthen processes, including billing automation.

Qualifications:

  • Bachelor’s degree in Accounting, Business, Healthcare related field or equivalent experience

  • Minimum of 6-8 years of related experience in medical billing and/or insurance collections included at least 3 years of experience with Prior Authorization requirements, AR & Denial management, payer utilization management policies and appeals.

  • Certified in coding or similar coding management experience.

  • Lab & Diagnostic industry-based RCM experience would be a plus.

  • Management experience is required

Required Knowledge, Skills and Abilities:

  • Proficiency with medical billing systems, Microsoft Excel, medical terminology and basic procedure coding knowledge.

  • Knowledge of medical terminology and abbreviations, and health care nomenclature and systems.

  • Ability to navigate across multiple customer demands and balance competing priorities successfully.

  • Ability to analyze, identify and articulate identified trends and report trends succinctly in a clear and concise manner.

  • Strong communication skills.

  • 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 laboratory and manage growth for optimal success.

Physical Demands & Work Environment:

Job duties are performed in the employee’s home office; office space should be private and have internet access. Position requires the ability to use a computer keyboard, communicate over the telephone, and read printed or online material.

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.
San Carlos, CA
$1$1 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

Competitive 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!

For more information, visit www.natera.com.

Natera is proud to be an Equal Opportunity Employer. We are committed to ensuring a diverse and inclusive workplace environment, and welcome people of different backgrounds, experiences, abilities and perspectives. Inclusive collaboration benefits our employees, our community and our patients, and is critical to our mission of changing the management of disease worldwide.

All qualified applicants are encouraged to apply, and will be considered without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, age, veteran status, disability or any other legally protected status. We also consider qualified applicants regardless of criminal histories, consistent with applicable laws.

If you are based in California, we encourage you to read this important information for California residents.

Link: https://www.natera.com/notice-of-data-collection-california-residents/

Please be advised that Natera will reach out to candidates with a @natera.com email domain ONLY. Email communications from all other domain names are not from Natera or its employees and are fraudulent. Natera does not request interviews via text messages and does not ask for personal information until a candidate has engaged with the company and has spoken to a recruiter and the hiring team. Natera takes cyber crimes seriously, and will collaborate with law enforcement authorities to prosecute any related cyber crimes.

For more information:
- BBB announcement on job scams
- FBI Cyber Crime resource page