Serve as a subject matter expert for front-end revenue cycle functions, including EDI rejections, insurance verification, and claim submission processes.
Investigate and resolve complex billing issues that prevent claims from being successfully accepted by payers.
Analyze EDI rejection trends and payer-specific requirements to identify root causes and recommend corrective actions.
Partner with internal teams (billing operations, coding, patient access) and external vendors (clearinghouses, payers) to resolve systemic issues.
Develop and maintain reporting and dashboards (Excel, Power BI, SQL/Snowflake) to track rejection trends, performance metrics, and improvement opportunities.
Conduct root cause analysis on recurring front-end issues and implement process improvements to reduce claim errors and rework.
Support the development and optimization of workflows and quality controls related to claim submission and eligibility processes.
Monitor and evaluate the effectiveness of implemented solutions and track performance against key revenue cycle metrics.
Stay current on payer requirements, billing rules, and EDI standards, ensuring processes align with industry and regulatory expectations.
Lead or contribute to cross-functional projects aimed at improving front-end revenue cycle performance.

Requirements

Bachelor’s degree in Business, Healthcare Administration, or related field.
2–4+ years of experience in healthcare revenue cycle, with exposure to:
EDI / clearinghouse processes.
Insurance verification / eligibility.
Claim submission workflows.
Strong understanding of front-end billing processes and how they impact downstream reimbursement.

Benefits

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

Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills & Tools

EDI rejectionsinsurance verificationclaim submissionroot cause analysisreportingdashboardsExcelPower BISQLSnowflake

Soft Skills

problem solvingcommunicationcollaborationanalytical thinkingattention to detailproject managementleadership