Supervisor, Denials and Appeals

Position Summary:

The Supervisor, Billing Denials & Appeals works interactively with internal departments, patients and their healthcare providers regarding current billing practice for Natera, Inc. and NSTX, Inc. This includes patient education, educational materials, answering basic clinical and program inquiries, and helping coordinate access to therapies through the patient’s healthcare provider.

Job Responsibilities:

Monitor staff productivity.
Create sub-team SOP.
Update Natera Care, which is the platform used to organize pending prior authorization cases.
Generate monthly trend reports.
Assist with hiring, disciplinary, and performance evaluations. Has hiring/firing authority and/or significant impact on hiring/firing decisions.
Oversee the process of providing coverage for employee vacation and sick calls.
Provide back-up for scheduling as needed.
Provide department orientation for all direct reports and coordinates training per job description.
Liaison with other clinic managers/supervisors to promote ongoing communication and ensure accuracy.
Responsible for phone processes, to include: monitoring incoming calls to make sure staff is following protocols regarding customer service; responsible for departments reaching goals.
Assist manager in finding and implementing solutions to phone access problems.
Act as liaison between departments; attends appropriate business meetings, and assists manager with implementation of clinic policy, goals and objectives that relate to business functions.
Act as an escalated level of response for patient concerns and complaints; assists staff with enforcing policy
Called upon to represent clinic in organizational projects and assist manager with follow-through and implementation of ongoing projects.
Keep staff informed regarding new and changing policies and procedures.
Create positive working relationship between other clinic staff and outside vendors.
Promote a positive working environment through role modeling, team development, respect, and being fair and consistent.
Perform related and other duties as assigned/needed.
This role works with PHI on a regular basis both in paper and electronic form and have access to various technologies to access PHI (paper and electronic) in order to perform the job.
Employee must complete training relating to HIPAA/PHI privacy, General Policies and Procedure Compliance training and security training as soon as possible but not later than the first 30 days of hire.
Must maintain a current status on Natera training requirements.

QUALIFICATIONS:

Bachelor’s degree or equivalent experience. Degree in business administration, accountancy, sales, marketing, computer sciences, or similar preferred.
Minimum of 2 years directly related and progressively responsible experience.
Lead and/or supervisory experience preferred.

KNOWLEDGE, SKILLS, AND ABILITIES:

Ability to communicate effectively both orally and in writing.
Strong interpersonal skills.
Strong organizational skills; attention to detail.
Ability to proficiently use computer and standard office equipment.
Working knowledge of Microsoft Office.
Knowledge of payer eligibility and benefits.
Health care research and analysis skills sufficient to support payer research healthcare policy library and state management.
Ability to resolve associate issues effectively and efficiently.

PHYSICAL DEMANDS & WORK ENVIRONMENT:

Duties are typically performed in an office setting. This position requires the ability to use a computer keyboard, communicate over the telephone and read printed material.
Duties may require working outside normal working hours (evenings and weekends) at times.