RCM Claims Status Manager

Natera

RCM Claims Status Manager leading a remote team in timely claim status follow-up. Driving productivity and quality standards across various payer communications in healthcare billing operations.

Posted 5/26/2026full-timeRemote • 🇺🇸 United StatesMid-LevelSenior💰 $101,400 - $126,750 per yearWebsite

About the role

Key responsibilities & impact

Lead, coach, and develop a remote team of RCM claim specialists responsible for claim status follow-up and resolution activities
Oversee daily operations related to electronic claim status inquiries and payer communications across Medicare, Medicaid, and commercial insurance carriers
Ensure timely and accurate documentation of payer responses, claim statuses, denials, and follow-up actions within internal systems
Monitor productivity, quality, and turnaround time metrics to ensure departmental SLAs and performance expectations are consistently achieved
Identify claim processing trends, workflow bottlenecks, and payer-related issues impacting reimbursement or operational efficiency
Escalate and resolve complex claim discrepancies, EDI transaction issues, and payer response inconsistencies
Serve as a subject matter expert for 276/277 claim status transactions and related EDI workflows
Partner with Billing Operations, Denials, Payment Posting, Cash Applications, and other RCM teams to improve claim lifecycle management
Analyze reporting and operational data to identify opportunities for process improvement and automation
Support onboarding, training, and ongoing performance management of team members
Maintain compliance with company policies, payer requirements, HIPAA regulations, and internal quality standards
Assist leadership with operational reporting, staffing assessments, and workflow optimization initiatives

Requirements

What you’ll need

Bachelor’s degree or equivalent combination of education and relevant RCM experience
5+ years of progressive Revenue Cycle Management experience within healthcare billing operations
2+ years of leadership or people management experience within an RCM, claims, or billing operations environment
Strong understanding of healthcare claims workflows and payer follow-up processes
Hands-on experience with EDI transactions, specifically 276/277 claim status transactions
Experience working with Medicare, Medicaid, managed care, and commercial payer portals
Proven ability to manage remote teams and drive accountability in a high-volume production environment
Strong analytical, organizational, and problem-solving skills
Experience utilizing billing systems, clearinghouses, and payer systems to research and resolve claim issues
Advanced communication skills with the ability to collaborate cross-functionally and manage escalations effectively
Proficiency in Microsoft Excel and reporting tools used within RCM operations.

Benefits

Comp & perks

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
Generous employee referral program

ATS Keywords

✓ Tailor your resume

Applicant Tracking System Keywords

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

Hard Skills & Tools

Revenue Cycle Managementhealthcare billing operationsEDI transactions276/277 claim status transactionsclaim processingdata analysisprocess improvementautomationdocumentationclaim status follow-up

Soft Skills

leadershipcoachingteam developmentanalytical skillsorganizational skillsproblem-solving skillscommunication skillscollaborationaccountabilityperformance management