Associate Director - Insurance Verification, Coding & Billing Operations at Natera

, , United States -

Full Time

Start Date

Immediate

Expiry Date

09 Feb, 26

Salary

167400.0

Posted On

11 Nov, 25

Experience

10 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Leadership, Insurance Verification, Medical Coding, Billing Operations, Revenue Cycle Management, Data Analysis, Process Improvement, Mentoring, Coaching, Performance Management, Compliance, Automation, Customer Service, Communication, Teamwork

Industry

Biotechnology Research

Description

POSITION SUMMARY The Associate Director - Insurance Verification, Coding & Billing Operations effectively leads registration, insurance verification, patient & provider demographics, medical ICD-10 coding, claims billing and submissions related A/R teams while maintaining a full understanding of Natera’s billing information system and all aspects of revenue cycle management. The Associate Director manages the activities of the billing staff through daily supervision while overseeing relevant functions. The Associate Director executes and implements strategic goals utilizing their cross-functional teams. The Associate Director leads individuals who direct and plan daily workflow activities for billing staff members. The Associate Director functions as a member of the leadership team in strategic planning and advisory capacities. PRIMARY RESPONSIBILITIES Directs billing management and staff to ensure that 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. Leads high performance teams responsible for Data Entry and Insurance Verification, CPT and ICD-10 Coding, Denial and Accounts Receivable Management. Provides leadership, drives change, and facilitates process improvements. Establishes and maintains 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. Maintains and enhance billing policies and procedures for each function in the related revenue cycle process and ensure staff adherence to policies. Prepares detailed analyses and reports of billing and accounts receivable activity and results, including performance matrixes, bad debt expense and AR days outstanding. Manages for continuous improvements within the revenue cycle process. Effectively interacts with various functional areas. 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. 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 headcounts and inventory. Creates and holds billing leadership accountable for established performance and production standards. Maintains billing related quality patient outcomes. Interfaces with third party payers to resolve reimbursement issues and provides guidance to appropriate senior leadership regarding contracting challenges. Provides direction to and development of associates through daily coaching, the administration of performance management, and the creation and implementation of development plans. Prepares annual performance evaluations and recommends merit increase and bonus percentages. Promotes organizational efficiency, needed change and continuous quality improvement. Identifies and implements opportunities for automation and improved efficiency. Assists as needed to perform other related duties and special projects as required. 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 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. QUALIFICATIONS Bachelor’s Degree in related field or equivalent required Minimum of 8 years of experience in managing a high-volume, fast-growing billing office within the laboratory setting is preferred (staff of 50-100). Extensive knowledge of reimbursement, billing, coding and compliance regulations is required. Certified coder designation / certification by AAPC or AHIMA 5+ years of experience coding in the medical/healthcare billing area- Lab a plus KNOWLEDGE, SKILLS, AND ABILITIES Demonstrated leadership ability in a multi-site environment. 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. Active, visible and influential leadership style such as ability to directly engage, arrive at conclusions, drive consensus, and monitor actions in support of quality outcomes. Skilled in researching, interpreting, and presenting data in a concise manner. Demonstrates strong ability to effectively plan, organize, and delegate. Leads by example and demonstrates commitment to continual improvement and a passion for excellence. Maintains a high standard of discipline, professionalism, and sound decision making for excellence. Ability to motivate a highly successful team to exceed performance goals, drive change, and lead a growing staff. Personable, persuasive, and comfortable navigating all levels of the workforce. Communication – Proficient verbal and written communication skills. Willingness to share and receive information and ideas from all levels of the organization in order to achieve the desired results. Teamwork – Commitment to the successful achievement of team and organizational goals through a desire to participate with and help other members of the team. Customer Service Focus – Demonstrate a focus on listening to and understanding client/customer needs and then delighting the client/customer by exceeding service and quality expectations 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. Austin, TX $133,900—$167,400 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

Responsibilities

The Associate Director leads registration, insurance verification, medical coding, and billing operations while managing the billing staff and ensuring accurate claims submission and timely collections. They also drive process improvements and collaborate with various functional areas to enhance billing services.