Supervisor, Denials and Appeals

Supervisor, Denials And Appeals

Natera is a global leader in cell-free DNA (cfDNA) testing, dedicated to transforming the management of genetic diseases through advanced technology, scientific excellence, and personalized care. Our mission is to change how the world diagnoses and treats disease and to improve outcomes for millions of patients.

The Supervisor, Denials And Appeals is responsible for leading a team focused on resolving complex claim denials and managing insurance appeals. This includes reviewing and triaging denied claims, conducting root cause analysis to determine denial codes and reasoning, gathering payor intel and preparing and submitting appeals. This role is pivotal in driving efficiency and productivity of the team, ensuring accurate reimbursement, minimizing denials, and improving payer relationships through data-driven insights and strong leadership. The Supervisor will also be responsible for tracking and reporting on team productivity, root causes and denial trends, and implementing proactive solutions that enhance our revenue cycle performance.

Lead and coach the Denials and Appeals team, ensuring productivity, accuracy, and compliance with payer requirements.

Handle escalations of complex denied claims, gather payor intel, identify root causes, and utilize data to develop strategies to prevent recurring issues.

Oversee the preparation and submission of well-documented appeals to maximize overturn success rates.

Monitor payer trends and collaborate with internal teams to improve claim accuracy and billing processes.

Track and report key performance metrics, including denial rates, appeal success rates, and turnaround times.

Foster a culture of accountability, teamwork, and continuous improvement within the department.

Ensure compliance with HIPAA, PHI, and all relevant billing and regulatory standards.

Associate or bachelor's degree in healthcare administration, Business, Finance, or related field (or equivalent years of relevant professional experience)

3+ years of revenue cycle experience, including 2+ years in a supervisory or team lead role overseeing a large team

Knowledge of medical billing, coding (ICD-10, CPT, HCPCS), payer reimbursement policies, and healthcare compliance

Proficient with revenue cycle systems (e.g., Epic, Cerner, Athenahealth, or similar EHRs)

Strong analytical, problem-solving, and organizational skills (advanced proficiency in Excel and experience utilizing Power BI is strongly preferred)

Excellent communication and interpersonal abilities

Ability to manage multiple tasks and meet deadlines in a fast-paced environment

Certification in Healthcare Revenue Cycle (e.g., CRCS, CRCP)

Experience in laboratory billing

Familiarity with government and commercial payer requirements

This position requires regular access to Protected Health Information (PHI) and adherence to all privacy and security standards.