Revenue Cycle Analyst - Denials & Appeals
Natera
Summary
The Revenue Cycle Analyst will be responsible for building and maintaining collaborative and productive relationships within the organization relating to Revenue Cycle Management, managing revenue cycle projects, driving performance in operations related to reimbursement and providing direction and oversight of processes impacting cash collections.
Job description
Job Responsibilities
- Serves as the primary source of knowledge for the designated revenue cycle function.
- Performs analysis, identifies trends, presents opportunity areas, and prioritizes initiatives for performance improvement for the designated revenue cycle function.
- Responsible for ensuring appropriate configuration of systems and workflows for designated revenue cycle function.
- Establishes an ongoing working relationship with other departments impacting revenue cycle performance.
- Works closely with the vendor operations teams to oversight operations activity that directly impact the revenue cycle to accurately process actions in a timely manner for optimal reimbursement.
- Tracks on-going performance of revenue cycle metrics and activities to ensure goals are met.
- Leads weekly meetings to review key metrics, workflows, trends, and performance improvement opportunities.
- By continually reviewing and monitoring billing and coding changes, researches, evaluates, and interprets guidance from a variety of sources to determine departmental actions.
- Coordinates with Management to ensure thorough understanding of trends/issues affecting revenue cycle performance.
- Develops 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.
- Acts as an educator on performance improvement requirements in operations and methodologies to related teams and departments.
- Continuously seek new and creative technologies that help identify and guide improvement opportunities that align with overall company success.
- Responsible for ongoing denial trend research and analysis, including evaluation of clinical, coding and reimbursement policies, and translating that information into action plans that drive end-to-end performance improvement.
Qualifications
Bachelor's Degree in business, analytics or healthcare related field of study, or equivalent years of relevant experience. At least 4-6 years of experience in medical billing and Insurance collections. Advanced knowledge of CPT/HCPCS, ICD-10, modifier selection, and UB revenue codes.
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.
- Strong communication (verbal and written), organizational, problem solving and team player skills.
- 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.
- Ability to independently solve complex problems using critical thinking skills.
- Maintains confidentiality of sensitive information.
- Analytical skills required.
- Ability to think critically and identify the global impact across the revenue cycle with a solution oriented approach.
- Ability to develop, implement and produce complex analysis and reports.
- Ability to motivate and create a team environment, prioritize work distribution, exceptional organizational and time management skills.
- Requires advanced project management skills, must be able to manage multiple projects.
Requirements
- Bachelor's Degree in business, analytics or healthcare related field of study, or equivalent years of relevant experience
- At least 4-6 years of experience in medical billing and Insurance collections
- Advanced knowledge of CPT/HCPCS
- Advanced knowledge of ICD-10
- Advanced knowledge of modifier selection
- Advanced knowledge of UB revenue codes
- Proficiency with medical billing systems
- Proficiency with Microsoft Excel
- Proficiency with medical terminology and basic procedure coding knowledge
- Knowledge of medical terminology and abbreviations, and health care nomenclature and systems
- Strong communication (verbal and written) skills
- Strong organizational skills
- Strong problem solving skills
- Team player skills
- 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
- Ability to independently solve complex problems using critical thinking skills
- Maintains confidentiality of sensitive information
- Analytical skills required
- Ability to think critically and identify the global impact across the revenue cycle with a solution oriented approach
- Ability to develop, implement and produce complex analysis and reports
- Ability to motivate and create a team environment
- Ability to prioritize work distribution
- Exceptional organizational and time management skills
- Requires advanced project management skills
- Must be able to manage multiple projects
Benefits
- Medical, Dental & Vision
- Life & Disability Insurance
- Free Testing
- Fertility Care Benefits
- Pregnancy & Baby Bonding Leave
- 401(k) Benefits
- Commuter Benefits
- Employee Referral Program
Company overview
Natera is a global leader in cell-free DNA (cfDNA) testing, specializing in molecular diagnostics for oncology, women's health, and organ health. Founded in 2004 and headquartered in Austin, Texas, the company has developed a cutting-edge cfDNA technology platform that combines novel molecular biology techniques with bioinformatics software and artificial intelligence. Natera's proprietary technology enables detection down to a single molecule in a tube of blood, making it possible to provide highly accurate genetic testing services. The company's flagship products include Signatera, a personalized circulating tumor DNA test for cancer monitoring; Panorama, a non-invasive prenatal test for chromosomal abnormalities; and Prospera, a transplant rejection assessment test. With over 4,400 employees and operations in CLIA-certified, CAP-accredited laboratories in Austin and San Carlos, California, Natera has processed more than 12 million tests and validated its technology through over 300 peer-reviewed publications. The company went public in 2015 and continues to innovate in precision medicine, aiming to make personalized genetic testing part of standard healthcare to enable earlier interventions and improved patient outcomes.