The opportunity
Natera is seeking an Associate Director, Billing Strategy – Denials & Appeals to lead the strategy, performance, and optimization of denied claims and appeals. This is a senior individual contributor role responsible for shaping denial management strategy, driving payer…
What you'll do
Operational: Oversight and performance management of outsourced RCM teams handling denials and appeals.
Analytical: Root cause analysis and data-driven insights to improve denial rates and recovery.
Technical: Defining and supporting system enhancements and automation strategies tied to denial workflows.
Lead denial management and appeals strategy across all payer types.
Define and track overturn rates, appeal timelines, and recovery performance.
Act as an internal expert on payer policies and medical necessity criteria for laboratory testing.
What they're looking for
- Interpret payer policies and guide teams on defending medical necessity in appeals.
- Identify payer behavior patterns to inform contracting strategy and escalation pathways.
- Partner with eligibility, prior authorization, coding, and billing teams to proactively prevent denials.
- Audit BPO/vendor performance using data to identify workflow gaps, enforce: accountability, and drive improvements.
