Supervisor, Denials & Appeals

The Denials & Appeals Supervisor oversees a team dedicated to assessing and tackling all functions related to denials and appeals management. This role drives consistency & accuracy of third-party payor billing information and improves processes to ensure claim denials and appeal efforts are tackled in a correct, proficient, and timely manner.

PRIMARY RESPONSIBILITIES:

• Supervise team including monitoring production and quality to specified goals.

• Assists with feedback for hiring, discipline and performance evaluations.

• Oversees the process of providing coverage for production environment.

• Provides department orientation for all direct reports and coordinates training per job description.

• Ensures that on-going training is provided for established employees, including the development & maintenance of standard operating procedures.

• Liaisons with internal departments to promote ongoing communication and ensure accuracy.

• Acts as an escalated level of response for concerns and complaints. 

• Assists staff with enforcing policy.

• Works with cross functionally to manage the entire process from insurance verification to final collection.

• Monitors and validates adherence to policies and procedures, auditing as necessary.

• Completes projects and reports in a timely fashion on a daily, weekly or monthly basis per the direction of management.

• Develops, monitors, coaches, and manages staff, ensuring the development of employees through orientation, training establishing objectives, communication of rules, constructive discipline.

• Promotes a positive working environment through role modeling, team development, respect, and being fair and consistent.

• This role may have occasional access to PCI and PHI both in paper and electronic form and could have occasional access to various technologies to access PCI and PHI (paper and electronic) in order to perform the job.

QUALIFICATIONS:

• Bachelor’s degree or equivalent experience.  Degree in business administration, accountancy, sales, marketing, or similar preferred.

• Minimum of 2 years directly related and progressively responsible experience.

• Team leadership and/or supervisory experience. 

• Experience with insurance claim denials and appeals management.

KNOWLEDGE, SKILLS, AND ABILITIES:

• Thorough knowledge of healthcare reimbursement environment (government and private payers) including coverage, coding and payment and understanding of insurance billing practices. 

• Demonstrated ability to develop and analyze payments, diagnose issues, and present findings to management. 

• Must be able to communicate effectively both orally and in writing. Strong interpersonal skills. 

• Strong organizational skills; attention to detail. 

• Ability to proficiently use computer and standard office equipment. 

• Working knowledge of Microsoft Office.

• Previous experience with Google Enterprise Suite – Gmail, Slides, Sheets, Docs, Drive. 

• Knowledge of payer eligibility and benefits. Health care research and analysis skills sufficient to support payer research healthcare policy library and state management. 

• Conflict resolution skills. Must be able to resolve employee issues effectively and efficiently. 

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