Revenue Cycle Analyst – Denials & Appeals

🔥 0 minutes ago

🇺🇸 United States – Remote

💵 $65.4k - $95.2k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

🧐 Analyst

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

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Natera

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 2004

🏥 Healthcare

🧬 Biotechnology

⚕️ Healthcare Insurance

Healthcare • Biotechnology • Healthcare Insurance

Natera is a global leader in cell-free DNA testing technology, specializing in non-invasive genetic testing and diagnostics. The company's innovative solutions focus on areas such as prenatal screening, cancer detection, and organ transplant monitoring. By using advanced bioinformatics and DNA analysis, Natera provides healthcare professionals and patients with critical information to make more informed medical decisions.

📋 Description

• Serve as the primary analytical resource for the Unresponded team, tracking and reporting post-appeal payer response activity across commercial and non-commercial plans • Monitor backlog aging, SLA adherence, appeal response rates, and resolution trends, surfacing findings to the Manager and leadership • Lead or support weekly metric review meetings and present trend analysis, workflow gaps, and performance improvement opportunities • Analyze unresponded appeal data to identify backlog root causes, payer-specific delays, and prioritization patterns • Partner with the Manager to translate operational findings into workflow recommendations and technology/system improvement inputs • Support configuration and validation of billing systems and payer portal workflows • Collaborate with Denials & Appeals teams to document and quantify error trends and incorporate them into feedback loops • Track offshore and onshore team productivity metrics and support performance reporting • Research payer-specific appeal response requirements, billing and coding updates, and reimbursement policy changes; recommend departmental actions • Develop and maintain project plans for workflow builds, backlog reduction, and SLA improvement initiatives • Perform other duties as assigned

🎯 Requirements

• Bachelor's Degree in Business, Healthcare Administration, or a related field preferred • Advanced Excel and data analysis skills • Experience using SQL (basic level), PowerBI, and working with raw data sets highly preferred • Minimum 4–6 years of experience in medical billing, denials management, insurance collections, or revenue cycle operations • Experience working with or analyzing post-appeal payer response workflows • Familiarity with commercial and non-commercial payer plans and appeal processes required • Advanced knowledge of CPT/HCPCS, ICD-10, modifier selection, and UB revenue codes • Experience with multiple payer portals required; AMD experience preferred • Strong analytical skills and ability to work with large datasets, identify trends, and present findings clearly • Proficiency in Microsoft Excel required • Experience with billing platforms, payer portals, and reporting tools strongly preferred • Solid understanding of the appeals lifecycle, particularly post-submission tracking and resolution workflows • Ability to translate data insights into practical operational recommendations and support implementation • Strong project management skills and ability to manage multiple priorities in a high-volume environment • Effective communication across offshore teams, onshore leadership, and cross-functional technology stakeholders • Detail-oriented with strong organizational skills and ability to maintain accuracy under tight SLA-driven deadlines • Maintains confidentiality of PHI and handles sensitive patient and payer information

🏖️ Benefits

• Comprehensive medical, dental, vision, life and disability plans for eligible employees and their dependents • Free testing for employees and their immediate families • Fertility care benefits • Pregnancy and baby bonding leave • 401k benefits • Commuter benefits • Employee referral program