Remote Claims Optimization Analyst (EDI & Billing)

Embedded Shishya; United States; Remote; USD 76,000 - 100,000; Full time

Benefits offered by this job

Competitive benefits

Fertility care benefits

Free testing for employees and depend

401k benefits

Commuter benefits

Employee referral program

Job summary

Natera is seeking an EDI & Claims Operations Analyst to support the Claims Status Management function within Billing Operations. You will monitor the lifecycle of submitted claims, identify barriers, and drive resolution through analytics, automation, and cross-functional collaboration.

The ideal candidate has deep healthcare revenue cycle knowledge, strong analytical and problem-solving skills, and will investigate claim trends to improve acceptance rates and reimbursement speed.

Qualifications

• Bachelor's degree or equivalent combination of education and experience.
• 4+ years of healthcare revenue cycle experience.
• Experience with claim submission, claim status, and EDI operations.
• Strong understanding of healthcare claims workflows and payer processing.
• Experience researching and resolving claim transmission, acceptance, or rejection issues.
• Advanced Excel/Google Sheets for data analysis and reporting.
• Strong analytical, investigative, and problem-solving abilities.
• Ability to work independently and drive issues to resolution across multiple teams.
• Excellent communication and stakeholder management skills.

Responsibilities

• Monitor claim status activity across clearinghouses and payer systems.
• Analyze large claim populations to identify trends and bottlenecks.
• Investigate rejected, unacknowledged, delayed, or stuck claims and determine root causes.
• Partner with Billing Ops, Verification, Denials, Coding, Configuration, Engineering, and Automation teams to resolve issues.
• Identify opportunities to automate manual claim status workflows.
• Serve as SME on clearinghouse operations, payer connectivity, and claim status processes.
• Research payer-specific requirements and status behaviors.
• Develop workflow improvement recommendations to increase acceptance and reduce denials.
• Track and trend claim status performance metrics for leadership.
• Support automation solutions related to claim status management.
• Create process documentation and job aids for standardized workflows.
• Assist with escalation management and complex routing decisions.
• Collaborate to identify systemic issues and implement corrective actions.

Skills

Excel/Google Sheets

Healthcare revenue cycle

Data analysis

Root-cause investigation

Independent work

Stakeholder management

Communication

Education

Bachelor's degree or equivalent

Tools

Snowflake

Power BI

Tableau

SQL

Job description

Natera is seeking an EDI & Claims Operations Analyst to support the Claims Status Management function within Billing Operations. You will monitor the lifecycle of submitted claims, identify barriers, and drive resolution through analytics, automation, and cross-functional collaboration.

The ideal candidate has deep healthcare revenue cycle knowledge, strong analytical and problem-solving skills, and will investigate claim trends to improve acceptance rates and reimbursement speed.