Manager, Insurance Operations
Adaptive Biotechnologies Corp.
full-time
Posted on:
Location Type: Remote
Location: United States
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Salary
💰 $101,600 - $152,400 per year
About the role
- Oversee workflows for contracted payer denials and underpaid claims.
- Develop and implement strategies to reduce denials and recover underpayments.
- Monitor denial trends and collaborate with internal teams to address root causes.
- Collaborate with payer relations and contracting teams for denial trends.
- Manage insurance follow-up queues to ensure timely and accurate responses to payer requests.
- Establish performance metrics and monitor team productivity for follow-up activities.
- Serve as an escalation point for complex payer issues.
- Oversee negotiation and execution of Letters of Agreement and Single Case Agreements with non-contracted payers.
- Ensure agreements are documented, compliant, and aligned with organizational reimbursement goals.
- Manage and mentor team responsible for denials, underpayments, and payer follow-up.
- Provide training and guidance to ensure adherence to policies and best practices.
- Foster a culture of accountability, collaboration, and continuous improvement.
- Prepare and analyze reports on denial rates, recovery performance, and payer trends.
- Present findings and recommendations to senior leadership for process optimization.
Requirements
- Bachelor's degree in Healthcare Administration, Business, or related field (or equivalent experience).
- 8+ years of experience in reimbursement operations, revenue cycle management, or payer relations.
- Strong knowledge of insurance billing, payer contracts, and reimbursement methodologies.
- Proven leadership experience with the ability to manage teams and drive performance.
- Excellent communication, negotiation, and problem-solving skills.
- Proficiency in revenue cycle systems (Quadax preferred) and Microsoft Office Suite.
Benefits
- equity grant
- bonus eligible
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
reimbursement operationsrevenue cycle managementinsurance billingpayer contractsreimbursement methodologiesperformance metricsreport analysisdenial managementpayer follow-up
Soft Skills
leadershipcommunicationnegotiationproblem-solvingteam managementcollaborationaccountabilitycontinuous improvementtraining