🛠 Tech Stack

💼 About This Role

You'll lead denial management and appeals strategy for laboratory testing, partnering cross-functionally to improve reimbursement outcomes. You'll drive payer advocacy and automation initiatives to scale workflows through technology. This role uniquely combines operational oversight, analytical root cause analysis, and technical system enhancements.

🎯 What You'll Do

• Define and track overturn rates, appeal timelines, and recovery performance.
• Translate denial workflows into system logic for automation.
• Audit BPO/vendor performance using data to drive improvements.
• Analyze denial trends to distinguish operational vs. payer-driven issues.

📋 Requirements

• 8–12+ years in healthcare Revenue Cycle Management focused on denials and appeals.
• Expertise in laboratory billing and CPT coding strongly preferred.
• Deep knowledge of commercial, Medicare, Medicaid, and managed care payer policies.
• Demonstrated success improving appeal overturn rates and resolving medical necessity denials.

✨ Nice to Have

• Experience supporting automation initiatives in revenue cycle (rules engines, RPA).
• Familiarity with AI-driven workflow concepts in an operational setting.
• Experience with AMD or similar billing platforms.

🎁 Benefits & Perks

• 🏖️ Comprehensive medical, dental, vision
• 🏥 Free genetic testing for employees and family
• 👶 Pregnancy and baby bonding leave
• 💰 401k benefits
• 🚆 Commuter benefits

📨 Hiring Process

Estimated timeline: 2-4 weeks · AI estimate

1. 1Recruiter call· 30 min
2. 2Hiring manager interview· 45 min
3. 3Technical/strategy interview· 60 min