Senior Revenue Operations Analyst

At Adaptive, we’re Powering the Age of Immune Medicine.  Our goal is to harness the power of the adaptive immune system to transform the way diseases are diagnosed and treated.

As an Adapter, you’ll have the opportunity to make a difference in people’s lives. With Adaptive, you’ll create a career highlight through collaboration with bright, curious colleagues working at the apex of innovation and application.

It’s time for your next chapter. Discover your story with Adaptive.

Position Overview

The Sr Revenue Operations Analyst – Insurance Eligibility and Discovery is responsible for overseeing Revenue and Reimbursement collections daily efforts, utilizing actionable data, and preparing detailed analysis. As a partner to the Reimbursement team, this position will deliver ad-hoc and long-term data-driven projects and reporting needs, as well as serve as the reimbursement operations expert for front-end order submission and be focused on driving the efficiency and accuracy of insurance verification processes critical to the organization's reimbursement success. This role requires a deep understanding of healthcare billing and insurance eligibility to not only execute but also innovate within existing workflows. High attention to detail and thorough-investigative abilities are necessary to ensure quality reporting and to deliver data driven decisions. Strong understanding of commercial insurance billing including appeals, denial processes and institutional billing.

Key Responsibilities and Essential Functions

• Ensure daily reimbursement claim processes and billing operations effectiveness.
• Collaborate with reimbursement and finance team, utilizing available technologies and system for analysis to optimize and automate processes.
• Produce effective and actionable metric reporting for all revenue operations related matters.
• Track and investigate trends, performance, and potential issues.
• Lead the end-to-end insurance eligibility and discovery processes for all orders, ensuring the accuracy of insurance data before activation in the lab.
• Partner strategically with Clinical Services, Customer Operations, and the Prior Authorization teams to design and refine workflows that enhance order activation efficiency and compliance.
• Review and interpret data from external eligibility providers to ensure insurance information is precise, actionable, and seamlessly integrated into claims processes.
• Maintain and enhance the organization’s billing portal access and functionality, ensuring adaptability for evolving payer requirements.
• Develop and deliver training for internal teams and provide ongoing education on best practices for eligibility verification and insurance compliance.
• Proactively identify opportunities to streamline insurance workflows, leveraging data analytics and cross-functional input to drive efficiency and scalability.
• Collaborate with revenue cycle management teams to mitigate claim errors, reduce denials, and identify trends affecting reimbursement success.
• Work closely with the revenue cycle management teams to verify that insurance information is accurately reflected on claims, minimizing errors and denials.
• Monitor eligibility discrepancies, troubleshoot errors, and resolve insurance information issues promptly, coordinating with internal and external stakeholders as necessary.
• Ensure that all orders meet payer requirements by confirming correct and complete insurance information prior to lab activation.
• Update insurance and eligibility documentation to maintain a record of verification processes and outcomes, supporting internal compliance and audit requirements.
• Participate in training sessions with external data providers to stay updated on best practices for eligibility verification and insurance data handling.
• Identify processes to improve data-influenced decision making and drive efficiencies in business processes.
• Serve as SME for all billing operations and processes.

Position Requirements (Education, Experience, Other)

Required

• Bachelors + 5 years of related experience.
• Experience with data visualization software and analytics best practices. Experience with Tableau and Tableau Server preferred.
• Experience working with business teams to define, optimize, and monitor end-to-end business reporting processes.
• Experience with revenue cycle management and external eligibility data providers.
• 5+ years of experience in healthcare billing, insurance eligibility, or reimbursement operations.
• Strong understanding of medical billing processes, insurance verification, and payer requirements.
• Experience coordinating with cross-functional teams to validate and manage insurance data.
• Familiarity with insurance codes, policies, and eligibility verification processes.
• Excellent attention to detail, with the ability to handle complex insurance information accurately.
• Knowledge of healthcare compliance standards, including HIPAA and other relevant regulations.
• Proficiency with billing and reimbursement software systems, as well as data entry and record-keeping tools.
• Strong written and verbal communication skills for effective collaboration with internal and external partners.
• Demonstrated ability to work independently in a fast-paced environment while managing multiple tasks and priorities.

#LI-Remote

Compensation

Salary Range: $79,400 - $119,200

Other compensation elements include:

• equity grant
• bonus eligible

ALERT: Malicious groups posing as Adaptive employees have recently used fraudulent email aliases to extend employment offers, provide fake documents, and request sensitive personal and financial information. Legitimate Adaptive employment opportunities are initiated through our careers page and extended after multiple interviews with verified employees. Adaptive does not ask new hires to purchase anything out-of-pocket, including home office supplies and equipment. 

Interested in this position, but don’t meet all the requirements?  Adaptive is committed to building diverse, equitable, and inclusive teams across our organization.  Please consider applying even if your experience doesn’t match all the qualifications; you may be the exact candidate we’re searching for!

Adaptive is not currently sponsoring candidates requiring work authorization support for this position.

Adaptive’s posted compensation information includes a base salary (or hourly rate) range and summary of other available total compensation. The base salary range represents a minimum-to-maximum salary (or hourly rate) available to candidates upon extension of offer. Base salary is thoughtfully considered upon offer and is determined through multiple evaluation checks throughout the interview process, including: a candidate’s ability to meet minimum qualifications (skills/experience/education), a candidate’s ability to thoughtfully address preferred qualifications, current market conditions, and internal pay equity. Listed base salary is exclusive of bonus, commission, equity, differential pay, benefits, and other incentives.

Adaptive's benefits at-a-glance.

Adaptive Biotechnologies is an Affirmative Action and Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, or protected veteran status and will not be discriminated against based on disability. Please refer the Equal Employment Opportunity Posters for more information. If you’d like to view a copy of the company’s affirmative action plan or policy statement, please email hr@adaptivebiotech.com.

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NOTE TO EMPLOYMENT AGENCIES: Adaptive Biotechnologies values our relationships with our Recruitment Partners and will only accept resumes from those partners who have active agreements with Adaptive. Adaptive Biotechnologies is not responsible for any fees related to resumes that are unsolicited or are received by any employee of Adaptive Biotechnologies who is not a member of the Human Resources team.