Associate Director, Billing Strategy - Denials & Appeals

Scorpion Therapeutics; United States; Remote; USD 132,000 - 165,000; Full time

Job summary

Scorpion Therapeutics seeks a senior leader to oversee denial management and appeals within the revenue cycle for a biopharma testing setting. You will drive reimbursement optimization, cut denial rates, and push automation in workflows.

You’ll develop payer advocacy strategies, analyze denial root causes, and manage offshore vendor performance while partnering with engineering on automation like rules engines and RPA.

Qualifications

• 8–12+ years in healthcare RCM with laboratory billing experience.
• Expertise in CPT coding and payer policies across commercial, Medicare, Medicaid.
• Experience with automation initiatives and working with offshore vendors.

Responsibilities

• Oversee denial management and appeals strategies within revenue cycle management.
• Optimize reimbursement, reduce denial rates, and enhance automation in denial workflows.
• Develop payer advocacy strategies and analyze root causes of denials.
• Manage outsourced RCM vendor performance and partner with engineering on automation (rules engines, RPA).
• Interpret payer policies and guide internal teams on medical necessity appeals.
• Use Power BI/SQL/Snowflake to identify denial patterns and financial impact.

Skills

Denial management

Appeals strategies

Revenue cycle management

Payer policies

Automation initiatives

Vendor management

Root cause analysis

Cross-functional collaboration

Data-driven decision making

Healthcare billing

Tools

Power BI

SQL

Snowflake

Job description

Role

Senior leader overseeing denial management and appeals strategies within revenue cycle management for a biopharma laboratory testing company. Objectives include optimizing reimbursement, reducing denial rates, and enhancing automation in denial workflows. Responsibilities encompass developing payer advocacy strategies, analyzing root causes of denials, managing outsourced RCM vendor performance, and partnering with engineering teams to implement automation solutions like rules engines and RPA. The role involves interpreting payer policies, guiding internal teams on medical necessity appeals, and leveraging data tools (Power BI, SQL, Snowflake) to identify denial patterns and financial impacts.

Qualifications

Qualifications include 8–12+ years in healthcare RCM with expertise in laboratory billing, CPT coding, and payer policies across commercial, Medicare, Medicaid, and managed care. Experience with automation initiatives, billing platforms like AMD, and working with offshore vendors is preferred. The position demands strong analytical, cross-functional collaboration skills, and a proactive, investigative approach to system and process improvements.

Location & Compensation

Remote within the USA, with a compensation range of $132,100–$165,100.