Revenue Cycle Analyst - Denials & Appeals

The Revenue Cycle Analyst – Denials & Appeals (Unresponded) supports the post-appeal response tracking function within Natera's Billing Operations by providing data-driven insights, workflow analysis, and performance reporting. This role works closely with the Manager of the Unresponded Team to identify backlog trends, monitor SLA compliance, and support the development and implementation of operational and system-based workflow improvements. The Analyst serves as a key analytical resource bridging offshore and onshore team performance with strategic priorities across the Denials & Appeals department.

Responsibilities

Serves as the primary analytical resource for the Unresponded team, tracking and reporting on post-appeal payer response activity across commercial and non-commercial plans; Monitors key performance metrics including backlog aging, SLA adherence, appeal response rates, and resolution trends; Leads or supports weekly metric review meetings, presenting trend analysis, workflow gaps, and performance improvement opportunities; Analyzes unresponded appeal data to identify root causes of backlog growth, payer-specific delays, and patterns that inform prioritization decisions; Partners with the Manager to translate operational findings into actionable workflow recommendations, including input for technology and systems teams on process improvement needs; Supports configuration and ongoing validation of billing systems and payer portal workflows to ensure accurate, timely tracking of appeal responses; Collaborates with the Denials & Appeals teams to ensure error trends identified within the unresponded scope are documented, quantified, and incorporated into feedback loops; Tracks offshore and onshore team productivity metrics and supports performance reporting for the Supervisor and leadership team; Researches payer-specific appeal response requirements, billing and coding updates, and reimbursement policy changes across all plan types, translating findings into recommended departmental actions; Develops and maintains project plans supporting workflow builds, backlog reduction initiatives, and SLA improvement efforts; Performs other duties as assigned

Requirements

Advanced Excel and data analysis skills; Minimum 4–6 years of experience in medical billing, denials management, insurance collections, or revenue cycle operations; Experience working with or analyzing post-appeal payer response workflows; Familiarity with commercial and non-commercial payer plans and appeal processes required; Advanced knowledge of CPT/HCPCS, ICD-10, modifier selection, and UB revenue codes; Experience with multiple payer portals required; Proficiency in Microsoft Excel required; Solid understanding of the appeals lifecycle, particularly post-submission tracking and resolution workflows; Ability to translate data insights into practical operational recommendations and support their implementation; Strong project management skills with ability to manage multiple priorities simultaneously in a high-volume environment; Effective communicator across all levels — comfortable working with offshore teams, onshore leadership, and cross-functional partners including technology stakeholders; Detail-oriented with strong organizational skills and ability to maintain accuracy under tight SLA-driven deadlines; Maintains confidentiality of PHI; this role regularly accesses sensitive patient and payer information in both paper and electronic form

Nice to have

Bachelor's Degree in Business, Healthcare Administration, or a related field preferred; Experience using SQL (basic level), PowerBI, and working with raw data sets is highly preferred; AMD experience preferred; Experience with billing platforms, payer portals, and reporting tools strongly preferred

Benefits

Comprehensive medical, dental, vision, life and disability plans; Free testing for employees and their immediate families; Fertility care benefits; Pregnancy and baby bonding leave; 401k benefits; Commuter benefits; Employee referral program