Natera
RCMClaimsStatusManager
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“RCM Claims Status Manager at Natera. Skills: Revenue Cycle Management, Claims Status Management, Team Leadership. Lead, coach, and develop a remote team. Oversee daily operations related to electronic claim status inquiries”
What You'll Achieve.
Drive productivity and quality standards; Ensure departmental SLAs and performance expectations are consistently achieved; Improve claim lifecycle management; Identify opportunities for process improvement and automation
Industry & Context.
Identify workflow inefficiencies; Escalate and resolve complex claim discrepancies, EDI transaction issues, and payer response inconsistencies; analytical, organizational, and problem-solving skills
What They're Looking For.
Must Have
Bachelor's degree or equivalent combination of education and relevant RCM experience, 5+ years of progressive Revenue Cycle Management experience within healthcare billing operations, 2+ years of leadership or people management experience within an RCM, claims, or billing operations environment, 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, analytical, organizational, and problem-solving skills, 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
Nice to Have
Experience within molecular diagnostics, laboratory billing, or high-complexity healthcare reimbursement environments, Familiarity with clearinghouse platforms and claim status automation tools, Experience leading operational improvement or workflow optimization initiatives, Knowledge of denials management, payment posting, or cash application workflows, Lean, Six Sigma, or process improvement experience is a plus
What You'll Do.
and develop a remote team
Oversee daily operations related to electronic claim status inquiries
Ensure timely and accurate documentation of payer responses
and turnaround time metrics
Identify claim processing trends
Escalate and resolve complex claim discrepancies
Serve as a subject matter expert for 276/277 transactions
Partner with Billing Operations and other RCM teams
Analyze reporting and operational data
and performance management
Maintain compliance with company policies
Assist leadership with operational reporting
How You'll Work.
Team & Collaboration
Partner cross-functionally to resolve claim processing issues; Partner with Billing Operations, Denials, Payment Posting, Cash Applications, and other RCM teams to improve claim lifecycle management; Advanced communication skills with the ability to collaborate cross-functionally and manage escalations effectively
Communication Scope
Advanced communication skills with the ability to collaborate cross-functionally and manage escalations effectively
Full Job Description
RCM Claim Status Manager Position Summary The RCM Claim Status Manager is a fully remote leadership role within Natera’s Billing Operations / Revenue Cycle Management organization. This individual will oversee a team responsible for the accurate and timely retrieval, review, and documentation of claim status information across a broad range of third-party payers, including Medicare, Medicaid, managed care organizations, and commercial insurance carriers. This role is highly operational and execution focused. 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. The successful candidate is organized, detail-oriented, metrics-driven, and comfortable operating in a high-volume environment where accountability, responsiveness, and process consistency are critical. Key Responsibilities Lead, coach, and develop a remote team of RCM claim specialists responsible for claim status follow-up and resolution activities Oversee daily operations related to electronic claim status inquiries and payer communications across Medicare, Medicaid, and commercial insurance carriers 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 Escalate and resolve complex claim discrepancies, EDI transaction issues, and payer response inconsistencies Serve as a subject matter expert for 276/277 claim status transactions
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