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Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in medical billing systems, eligibility and prior authorization processes, and revenue cycle management. Proficient in data analysis, trend identification, and developing performance improvement initiatives aligned with organizational goals.
Highest-signal resume keywords
Medical Billing Systems ProficiencyEligibility And Prior Authorization KnowledgeData Analysis And ReportingCPT/HCPCS And ICD-10 KnowledgeBachelor's Degree In Healthcare
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Medical BillingInsurance CollectionsBasic Procedure CodingData AnalysisTrend IdentificationPerformance ImprovementRevenue Cycle ManagementCPT/HCPCS KnowledgeICD-10 KnowledgeUB Revenue Codes
Soft Skills
Strong Communication SkillsOrganizational SkillsProblem-Solving SkillsTeam PlayerCritical Thinking
Tools & Technologies
Microsoft Excel
Industry Keywords
Healthcare NomenclaturePayer Utilization Management PoliciesConfidentiality Of Sensitive InformationVendor OperationsClaims And Appeals Processing
About the role
Key responsibilities & impact- Build and maintain collaborative relationships with internal and external eligibility and prior authorization stakeholders
- Drive operational performance related to reimbursement and provide direction and oversight of processes affecting cash collections
- Serve as a source of knowledge for the designated revenue cycle function
- Analyze data, identify trends, present opportunity areas and prioritize performance-improvement initiatives
- Establish working relationships with departments affecting revenue cycle performance
- Oversee vendor operations for prior authorization, claims and appeals to ensure timely, accurate processing
- Research, evaluate and interpret eligibility and prior authorization guidance to determine departmental actions
- Coordinate with management regarding trends and issues affecting revenue cycle performance
- Develop goals and metrics linking department and revenue cycle initiatives with organizational strategy
- Develop, manage and monitor implementation and project plans
- Seek technologies that identify and guide improvement opportunities aligned with company success
Requirements
What you’ll need- Proficiency with medical billing systems, Microsoft Excel, medical terminology and basic procedure coding knowledge
- Knowledge of medical terminology and abbreviations, and health care nomenclature and systems
- Strong communication, organizational, problem solving and team player skills
- Ability to navigate multiple customer demands and balance competing priorities
- Ability to analyze, identify and articulate trends and report them clearly and concisely
- Critical thinking and problem-solving skills
- Ability to maintain confidentiality of sensitive information
- Analytical skills
- Ability to identify revenue cycle impact with a solution-oriented approach
- Ability to develop, implement and produce analysis and reports
- At least 3 years of experience in medical billing and insurance collections
- At least 3 years of experience with eligibility and prior authorization requirements, payer utilization management policies and appeals
- Knowledge of CPT/HCPCS, ICD-10, modifier selection and UB revenue codes
- Bachelor's Degree
- Healthcare-related field of study or equivalent experience
Benefits
Comp & perks- Comprehensive medical, dental, vision, life and disability plans for eligible employees and their dependents
- Free testing for Natera employees and their immediate families
- Fertility care benefits
- Pregnancy and baby bonding leave
- 401k benefits
- Commuter benefits
- Employee referral program