Remote Billing Strategy Architect — Denials & Appeals

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

Job summary

Natera is seeking an Associate Director, Billing Strategy – Denials & Appeals to lead strategy, performance, and optimization of denied claims. You will shape denial management, drive payer advocacy, and partner across functions to improve reimbursement outcomes.

You will also guide automation initiatives across denial workflows, translating clinical and operational insights into system logic with engineering collaboration for scalable processes.

Qualifications

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

Responsibilities

• Lead denial management and appeals strategy across payer types.
• Track overturn rates, timelines, and recovery performance.
• Define payer policy criteria for lab testing and medical necessity.
• Collaborate with eligibility, prior auth, coding, and billing to prevent denials.
• Audit BPO/vendor performance and drive workflow improvements.
• Translate denial workflows into system logic and support automation.
• Lead UAT/QA for system changes affecting denial processes.
• Analyze denial trends using Power BI or SQL to quantify impact.

Skills

RCM Denials & Appeals

Laboratory Billing

CPT Coding

Payer Policy Knowledge

Vendor Management

Power BI

Excel

SQL

Snowflake

Cross-functional Leadership

Tools

Power BI

Excel

SQL

Snowflake

Job description

Natera is seeking an Associate Director, Billing Strategy – Denials & Appeals to lead strategy, performance, and optimization of denied claims. You will shape denial management, drive payer advocacy, and partner across functions to improve reimbursement outcomes.

You will also guide automation initiatives across denial workflows, translating clinical and operational insights into system logic with engineering collaboration for scalable processes.