Note: The job is a remote job and is open to candidates in USA. Natera is a global leader in cell-free DNA testing and genetic diagnostics focused on oncology, women’s health, and organ health. The Associate Revenue Cycle Analyst – Billing serves as a subject matter expert for clean claim submission, investigating billing and claim rejection issues, analyzing data, and implementing sustainable solutions. The role independently manages complex improvement initiatives and partners with cross-functional teams to improve claim accuracy, payer acceptance, and revenue cycle performance.
Responsibilities
- Serve as a subject matter expert for clean claim submission and front-end billing processes, with a strong understanding of the claim lifecycle from claim creation through payer receipt and acceptance
- Analyze claim rejections and operational data to identify trends, recurring issues, root causes, and opportunities to improve clean claim performance
- Investigate EDI and clearinghouse rejections, duplicate submission issues, incorrect or missing ICN information, prior authorization-related rejections, provider enrollment and NPI registration issues, patient demographic errors, and other claim submission barriers
- Research rejection reasons, determine the root cause, and provide all of the necessary information, documentation, system corrections, or operational changes to the appropriate cross-functional teams in order to resolve them
- Evaluate identified issues beyond the individual claim to determine the broader claim population, payer, workflow, or business processes impacted
- Identify upstream causes of claim rejections and develop sustainable solutions designed to prevent recurrence and reduce downstream denials
- Use SQL and Snowflake to obtain and analyze claim and operational data, quantify issues, identify affected populations, validate root causes, and measure improvement
- Utilize advanced Excel functionality, including pivot tables and lookup functions, to analyze large datasets, identify meaningful trends, and create clear and actionable reporting
- Develop dashboards, reports, automation, tracking tools, and other analytical resources to improve visibility into claim submission and rejection performance
- Independently manage complex issue resolution and improvement initiatives from initial identification through completion, including coordinating cross-functional work, tracking progress, testing solutions, validating implementation, and monitoring post-implementation results
- Partner closely with Coding, Insurance Verification, Prior Authorization, provider enrollment, technology, vendor operations, and other teams whose processes impact clean claim submission and acceptance
- Maintain ownership of cross-functional issues rather than simply escalating or transferring them, ensuring identified problems are followed through to successful resolution
- Develop and improve workflows and SOPs that increase claim accuracy, operational efficiency, and first-pass payer acceptance
- Monitor key performance indicators, rejection trends, and operational performance to proactively identify emerging issues and opportunities for improvement
- Create and present detailed, executive-ready presentations communicating trends, root causes, remediation efforts, project status, and upstream and downstream revenue cycle impacts
- Translate complex billing and analytical findings into clear recommendations for operational teams and leadership
- Maintain knowledge of payer requirements, billing rules, EDI processes, and other changes affecting claim submission and acceptance
- Act as an educator and resource to operational teams regarding identified issues, process improvements, and best practices
- Proactively identify opportunities to leverage data, technology, automation, and workflow improvements to increase clean claim rates and prevent avoidable rejections and denials
Skills
- 2–3+ years of experience in medical billing, claims operations, revenue cycle management, insurance collections, or a related healthcare function
- Strong understanding of healthcare revenue cycle processes and the claim lifecycle, particularly claim creation, submission, clearinghouse processing, payer acceptance, rejection, and denial
- Working knowledge of medical billing and coding concepts, including CPT/HCPCS, ICD-10, modifiers, authorization requirements, payer requirements, and claim identifiers
- Proficiency with Microsoft Excel, including pivot tables, lookup functions, data manipulation, and analysis of large datasets
- Working knowledge of SQL and experience using a data warehouse or analytics platform such as Snowflake. Candidates should be able to independently obtain the data needed to answer business questions using SQL, including effectively leveraging AI-assisted query development when appropriate
- Demonstrated ability to analyze data, recognize patterns, investigate root causes, and translate findings into actionable operational solutions
- Strong project management and organizational skills with demonstrated ability to independently drive initiatives from problem identification through implementation and post-implementation monitoring
- Strong written and verbal communication skills, including the ability to create polished presentations and communicate detailed findings to leadership
- Ability to work autonomously, follow complex issues through multiple systems or teams, and proactively determine appropriate next steps
- Strong critical-thinking, problem-solving, and solution-oriented mindset
- Ability to quickly learn new revenue cycle processes, systems, technologies, and payer requirements
- Bachelor's degree in business, healthcare, analytics, or a related field preferred
- Experience investigating claim rejections, EDI transactions, clearinghouse issues, payer requirements, provider enrollment, or other front-end billing issues strongly preferred
Benefits
- Comprehensive medical, dental, vision, life and disability plans for eligible employees and their dependents
- Natera employees and their immediate families receive free testing
- Fertility care benefits
- Pregnancy and baby bonding leave
- 401k benefits
- Commuter benefits
- Generous employee referral program
Company Overview
Company H1B Sponsorship