Associate Director, Billing Strategy - Denials & Appeals

About this role

Associate Director, Billing Strategy – Denials & Appeals Position Summary Natera is seeking an Associate Director, Billing Strategy – Denials & Appeals to lead the strategy, performance, and optimization of denied claims and appeals. This is a senior individual contributor role responsible for shaping denial management strategy, driving payer advocacy, and partnering cross-functionally to improve reimbursement outcomes.

This role will also play a key part in supporting automation initiatives across denial and appeals workflows—translating operational expertise into system logic and partnering with engineering and vendors to scale processes through technology. The Associate Director will oversee this function from three angles: Operational: Oversight and performance management of outsourced RCM teams handling denials and appeals. Analytical: Root cause analysis and data-driven insights to improve denial rates and recovery.

Technical: Defining and supporting system enhancements and automation strategies tied to denial workflows. Key Responsibilities Strategy & Payer Advocacy Lead denial management and appeals strategy across all payer types. Define and track overturn rates, appeal timelines, and recovery performance. Act as an internal expert on payer policies and medical necessity criteria for laboratory testing. Interpret payer policies and guide teams on defending medical necessity in appeals.

Identify payer behavior patterns to inform contracting strategy and escalation pathways. Operations & Root Cause Analysis Partner with eligibility, prior authorization, coding, and billing teams to proactively prevent denials. Audit BPO/vendor performance using data to identify workflow gaps, enforce accountability, and drive improvements. Develop job aids and standardized workflows to improve consistency and quality.

Analyze denial trends to distinguish between avoidable operational issues and systemic or payer-driven challenges. Data, Systems & Automation Translate denial and appeals workflows into system logic, partnering with engineering and vendors to support automation buildout. Define requirements for rules-based workflows, denial routing, and appeal triggers within billing systems (e.g., AMD). Support automation initiatives (e.g., rules engines, RPA, AI-driven workflows) by providing domain expertise and guiding design decisions.