FreshRemote.Work

Associate Director, Revenue Cycle Management Audit and Process Improvement

Remote

We are seeking an experienced and strategic Associate Director, Revenue Cycle Management Audit and Process Improvement to build and manage a comprehensive audit program for our revenue cycle processes and personnel. The ideal candidate will have a proven track record of leading revenue cycle audits, preferably within the labs/medical testing industry, and possess a deep understanding of the entire labs process from sample intake to billing.

Key Responsibilities

  • Develop, implement, and manage a comprehensive audit program for revenue cycle, including process and personnel audits
  • Direct audits and analysis, identify trends, present opportunity areas, and prioritize initiatives for performance improvement
  • Identify areas of risk and recommend strategies to mitigate potential revenue loss
  • Monitor key performance indicators and SLAs to ensure optimal process and personnel performance
  • Collaborate with cross-functional teams, especially billing, to address audit findings and implement corrective actions
  • Review and improve auditing templates with an effective scoring methodology to monitor RCM team performance
  • Modify workflows, SOPs, and SLA tracking based on audit findings
  • Oversee vendor operations teams to ensure accurate and timely processing for optimal reimbursement
  • Lead weekly meetings to review key metrics, workflows, trends, and performance improvement opportunities
  • Develop performance goals and metrics aligned with the organization's strategy
  • Supervise and mentor audit staff to enhance professional development

Qualifications

  • Bachelor's degree in Accounting, Business, Healthcare related field, or equivalent experience
  • 8-10 years of related experience in medical billing and/or insurance collections, including 5-7 years of experience with Prior Authorization requirements, AR & Denial management, payer utilization management policies, and appeals
  • Certified in coding or similar coding management experience
  • Proven experience leading revenue cycle audits and managing audit programs
  • Lab & Diagnostic industry-based RCM experience
  • Management experience required

Required Skills

  • Ability to analyze information and create compelling stories at the executive level
  • Understanding of the entire labs process and ability to create scalable processes
  • Knowledge of denial reasons and resolution strategies
  • Strong communication and collaboration skills
  • Proficiency with medical billing systems, Microsoft Excel, medical terminology, and basic procedure coding
  • Motivated to be creative and brainstorm innovative solutions
  • Desire to work for a dynamic and growing molecular genetics laboratory

If you are passionate about driving performance improvement in revenue cycle management and thrive in a fast-paced, innovative environment, we'd love to hear from you. Join us in our mission to change the landscape of healthcare through cutting-edge molecular diagnostics.

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.Remote USA$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 

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Job Profile

Benefits/Perks

401k benefits Commuter benefits Competitive Competitive benefits Comprehensive medical Dental Employee Referral Program Fertility care benefits Free testing Life and disability plans Pregnancy and baby bonding leave Vision

Skills

Appeals Audit Management Basic procedure coding Billing Coding Collection Communication Cross-functional Teams Data analysis Excel Genetics Genetic Testing Healthcare Insurance collections Medical Billing Medical billing systems Medical terminology Microsoft Excel Molecular diagnostics Oncology Orientation Prior authorization Procedure Coding Process Improvement Reimbursement Revenue Cycle Management SOPS

Tasks
  • Analysis
  • Collaborate with cross functional teams
  • Develop audit program
  • Develop performance goals and metrics
  • Direct audits and analysis
  • Identify trends
  • Identify trends and opportunity areas
  • Implement corrective actions
  • Lead meetings to review key metrics
  • Monitor KPIs and SLAs
  • Oversee vendor operations teams
  • Performance improvement
  • Revenue cycle management
  • Review and improve auditing templates
  • Supervise and mentor audit staff
Experience

8 - 10 years

Education

Bachelor's Bachelor's degree Bachelor's degree in Accounting Business Genetics Healthcare Healthcare related field Oncology Related Field Software

Certifications

Certified in Coding