Associate Director, Billing Strategy - Denials & Appeals

📋 Description

• Lead the overall denial management and appeals strategy across commercial, Medicare, Medicaid
• Define and monitor key performance indicators including appeal overturn rates, appeal timelines
• Serve as a subject matter expert on payer policies, medical necessity criteria, laboratory testing
• Interpret payer policies and guide internal and outsourced teams in developing effective strategies
• Analyze payer behavior and denial patterns to identify systemic issues, inform payer advocacy
• Partner with eligibility, prior authorization, coding, billing, and other revenue cycle functions

🎯 Requirements

• 8–12+ years of healthcare Revenue Cycle Management experience, with deep specialization in denials
• Strong expertise in laboratory billing, CPT coding, reimbursement methodologies, medical necessity
• Comprehensive knowledge of commercial, Medicare, Medicaid, and managed care payer policies and
• Demonstrated success improving appeal overturn rates, resolving medical necessity denials, reducing
• Experience managing or partnering with BPO and offshore RCM vendors, including performance
• Strong analytical capabilities with hands-on experience using tools such as Power BI, Excel, SQL

🎁 Benefits

• Base salary: $132,100–$165,100 USD for the remote U.S. position.
• Compensation may vary based on skills, years and depth of experience, certifications, and specific
• Comprehensive medical, dental, and vision insurance for eligible employees and dependents.
• Life and disability insurance plans.
• Free testing for employees and their immediate families.
• Fertility care benefits.