other
Posted 3 hours agoRCM Claims Status Manager
at Natera
United StatesRemote
Responsibilities
- Lead, coach, and develop a remote team of RCM claim specialists responsible for claim status follow-up and resolution activities
- Ensure timely and accurate documentation of payer responses, claim statuses, denials, and follow-up actions within internal systems
- Monitor productivity, quality, and turnaround time metrics to ensure departmental SLAs and performance expectations are consistently achieved
- Identify claim processing trends, workflow bottlenecks, and payer-related issues impacting reimbursement or operational efficiency
- Analyze reporting and operational data to identify opportunities for process improvement and automation
- Support onboarding, training, and ongoing performance management of team members
- Maintain compliance with company policies, payer requirements, HIPAA regulations, and internal quality standards
Requirements
- The ideal candidate brings deep knowledge of revenue cycle workflows, EDI claim status transactions (particularly 276/277), payer portal navigation, and claim follow-up operations.
- They must be able to lead distributed teams, drive productivity and quality standards, identify workflow inefficiencies, and partner cross-functionally to resolve claim processing issues impacting reimbursement.
- Bachelor’s degree or equivalent combination of education and relevant RCM experience
- experience within healthcare billing operations
- experience within an RCM, claims, or billing operations environment
- Strong understanding of healthcare claims workflows and payer follow-up processes Hands-on
- experience with EDI transactions, specifically 276/277 claim status transactions •
- Experience working with Medicare, Medicaid, managed care, and commercial payer portals
- Proven ability to manage remote teams and drive accountability in a high-volume production environment
- Experience utilizing billing systems, clearinghouses, and payer systems to research and resolve claim issues
- Advanced communication skills with the ability to collaborate cross-functionally and manage escalations effectively
- Proficiency in Microsoft Excel and reporting tools used within RCM operations Preferred