Adaptive Biotechnologies Corp.

Every immune system has a story to tell; the key is knowing how to listen.

Manager, Insurance Operations

OperationsOperationsFull TimeRemoteTeam 501-1,000Since 2009H1B No SponsorCompany SiteLinkedIn

Location

United States

Posted

39 days ago

Salary

$101.6K - $152.4K / year

Bachelor Degree8 yrs expEnglish

Job Description

• Oversee workflows for contracted payer denials and underpaid claims. • Develop and implement strategies to reduce denials and recover underpayments. • Monitor denial trends and collaborate with internal teams to address root causes. • Collaborate with payer relations and contracting teams for denial trends. • Manage insurance follow-up queues to ensure timely and accurate responses to payer requests. • Establish performance metrics and monitor team productivity for follow-up activities. • Serve as an escalation point for complex payer issues. • Oversee negotiation and execution of Letters of Agreement and Single Case Agreements with non-contracted payers. • Ensure agreements are documented, compliant, and aligned with organizational reimbursement goals. • Manage and mentor team responsible for denials, underpayments, and payer follow-up. • Provide training and guidance to ensure adherence to policies and best practices. • Foster a culture of accountability, collaboration, and continuous improvement. • Prepare and analyze reports on denial rates, recovery performance, and payer trends. • Present findings and recommendations to senior leadership for process optimization.

Job Requirements

  • Bachelor's degree in Healthcare Administration, Business, or related field (or equivalent experience).
  • 8+ years of experience in reimbursement operations, revenue cycle management, or payer relations.
  • Strong knowledge of insurance billing, payer contracts, and reimbursement methodologies.
  • Proven leadership experience with the ability to manage teams and drive performance.
  • Excellent communication, negotiation, and problem-solving skills.
  • Proficiency in revenue cycle systems (Quadax preferred) and Microsoft Office Suite.

Benefits

  • equity grant
  • bonus eligible

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