Associate Director, Billing Strategy - Denials & Appeals

Natera; Austin (TX); Remote; USD 132,000 - 165,000; Full time

Job summary

Natera is seeking an Associate Director, Billing Strategy – Denials & Appeals to lead denial management strategy, drive payer advocacy, and partner across functions to improve reimbursement outcomes.

This senior role will oversee outsourcing partnerships, implement data-driven improvements, and guide system and automation enhancements in denial workflows. Strong analytical and communication skills are essential.

Qualifications

• 8–12+ years in healthcare Revenue Cycle Management (RCM) with focus on denials and appeals.
• Expertise in laboratory billing, CPT coding, and reimbursement methodologies.
• Strong knowledge of commercial, Medicare, Medicaid, and managed care payer policies.
• Demonstrated success improving appeal overturn rates and resolving medical necessity denials.
• Experience working with BPO or offshore RCM vendors.
• Strong analytical skills with experience using Power BI, Excel, SQL, or Snowflake.
• Experience leading cross-functional initiatives and influencing stakeholders without direct authority.

Responsibilities

• 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.
• 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 and drive improvements.
• Translate denial and appeals workflows into system logic and guide automation buildout.

Skills

Denials & Appeals

Power BI

SQL

Excel

Data analytics

Cross-functional leadership

Payer policies

Tools

Power BI

SQL

Snowflake

Jira

Job description

Associate Director, Billing Strategy - Denials & Appeals

US Remote

Associate Director, Billing Strategy – Denials & Appeals

Position Summary

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 advocacy, and partnering cross-functionally to improve reimbursement outcomes.

This role will also play a key part in supporting automation initiatives across denial and appeals workflows—translating operational expertise into system logic and partnering with engineering and vendors to scale processes through technology.

The Associate Director will oversee this function from three angles:

• 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.

Key Responsibilities

• 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.
• Interpret payer policies and guide teams on defending medical necessity in appeals.
• Identify payer behavior patterns to inform contracting strategy and escalation pathways.

Operations & Root Cause Analysis

• 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.
• Develop job aids and standardized workflows to improve consistency and quality.
• Analyze denial trends to distinguish between avoidable operational issues and systemic or payer-driven challenges.

Data, Systems & Automation

• Translate denial and appeals workflows into system logic, partnering with engineering and vendors to support automation buildout.
• Define requirements for rules-based workflows, denial routing, and appeal triggers within billing systems (e.g., AMD).
• Support automation initiatives (e.g., rules engines, RPA, AI-driven workflows) by providing domain expertise and guiding design decisions.
• Lead UAT and QA for system changes, ensuring outputs align with payer policy and real-world denial scenarios.
• Identify opportunities to reduce manual work by transitioning denial and appeal processes toward scalable, low-touch or unattended workflows.
• Proactively identify edge cases, failure points, and gaps in automation logic before and after deployment.
• Analyze datasets using tools such as Power BI, SQL, Excel, or Snowflake to quantify denial drivers and financial impact.

Qualifications

Required

• 8–12+ years of experience in healthcare Revenue Cycle Management (RCM), with deep focus on denials and appeals.
• Expertise in laboratory billing, CPT coding, and reimbursement methodologies.
• Strong knowledge of commercial, Medicare, Medicaid, and managed care payer policies.
• Demonstrated success improving appeal overturn rates and resolving medical necessity denials.
• Experience working with BPO or offshore RCM vendors.
• Strong analytical skills with experience using tools such as Power BI, Excel, SQL, or Snowflake.
• Experience leading cross-functional initiatives and influencing stakeholders without direct authority.

Preferred

• Experience supporting automation initiatives in revenue cycle (e.g., rules engines, RPA, or workflow automation tools).
• Experience partnering with engineering teams or vendors to implement billing system enhancements.
• Familiarity with AI-driven workflow concepts (e.g., intelligent routing, decisioning) in an operational setting.
• Experience with AMD or similar billing platforms.
• Experience with tools such as Jira or similar workflow tracking systems.

Key Traits for Success

• Investigative: Relentless in understanding why denials occur and how to prevent or overturn them.
• Systems Thinker: Able to connect operational workflows with system logic and automation opportunities.
• Data-Driven: Uses data to inform decisions and influence stakeholders.
• Cross-Functional Operator: Effectively partners with engineering, operations, and leadership teams.
• Builder Mindset: Proactive in identifying opportunities and driving improvements with a high degree of ownership.
• Low Ego, High Accountability: Focused on outcomes and team success over individual recognition.

The pay range is listed and actual compensation packages are based on a wide array of factors unique to each candidate, including but not limited to skill set, years & depth of experience, certifications and specific office location. This may differ in other locations due to cost of labor considerations.

Remote USA

$132,100 - $165,100 USD

OUR OPPORTUNITY

Natera™ is a global leader in cell-free DNA (cfDNA) testing, dedicated to oncology, women’s health, and organ health. Our aim is to make personalized genetic testing and diagnostics part of the standard of care to protect health and enable earlier and more targeted interventions that lead to longer, healthier lives.

The Natera team consists of highly dedicated statisticians, geneticists, doctors, laboratory scientists, business professionals, software engineers and many other professionals from world-class institutions, who care deeply for our work and each other. When you join Natera, you’ll work hard and grow quickly. Working alongside the elite of the industry, you’ll be stretched and challenged, and take pride in being part of a company that is changing the landscape of genetic disease management.

WHAT WE OFFER

Competitive Benefits - Employee benefits include comprehensive medical, dental, vision, life and disability plans for eligible employees and their dependents. Additionally, Natera employees and their immediate families receive free testing in addition to fertility care benefits. Other benefits include pregnancy and baby bonding leave, 401k benefits, commuter benefits and much more. We also offer a generous employee referral program!

Natera is proud to be an Equal Opportunity Employer. We are committed to ensuring a diverse and inclusive workplace environment, and welcome people of different backgrounds, experiences, abilities and perspectives. Inclusive collaboration benefits our employees, our community and our patients, and is critical to our mission of changing the management of disease worldwide.

All qualified applicants are encouraged to apply, and will be considered without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, age, veteran status, disability or any other legally protected status. We also consider qualified applicants regardless of criminal histories, consistent with applicable laws.

If you are based in California, we encourage you to read this important information for California residents.

Please be advised that Natera will reach out to candidates with a @ natera.com email domain ONLY. Email communications from all other domain names are not from Natera or its employees and are fraudulent. Natera does not request interviews via text messages and does not ask for personal information until a candidate has engaged with the company and has spoken to a recruiter and the hiring team. Natera takes cyber crimes seriously, and will collaborate with law enforcement authorities to prosecute any related cyber crimes.

Voluntary Self-Identification

For government reporting purposes, we ask candidates to respond to the below self-identification survey.Completion of the form is entirely voluntary. Whatever your decision, it will not be considered in the hiringprocess or thereafter. Any information that you do provide will be recorded and maintained in aconfidential file.

As set forth in Natera’s Equal Employment Opportunity policy,we do not discriminate on the basis of any protected group status under any applicable law.

If you believe you belong to any of the categories of protected veterans listed below, please indicate by making the appropriate selection.As a government contractor subject to the Vietnam Era Veterans Readjustment Assistance Act (VEVRAA), we request this information in order to measurethe effectiveness of the outreach and positive recruitment efforts we undertake pursuant to VEVRAA. Classification of protected categoriesis as follows:

A "disabled veteran" is one of the following: a veteran of the U.S. military, ground, naval or air service who is entitled to compensation (or who but for the receipt of military retired pay would be entitled to compensation) under laws administered by the Secretary of Veterans Affairs; or a person who was discharged or released from active duty because of a service-connected disability.

A "recently separated veteran" means any veteran during the three-year period beginning on the date of such veteran's discharge or release from active duty in the U.S. military, ground, naval, or air service.

An "active duty wartime or campaign badge veteran" means a veteran who served on active duty in the U.S. military, ground, naval or air service during a war, or in a campaign or expedition for which a campaign badge has been authorized under the laws administered by the Department of Defense.

An "Armed forces service medal veteran" means a veteran who, while serving on active duty in the U.S. military, ground, naval or air service, participated in a United States military operation for which an Armed Forces service medal was awarded pursuant to Executive Order 12985.