Adaptive Biotechnologies Corp.
Every immune system has a story to tell; the key is knowing how to listen.
Manager, Insurance Operations
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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