Naveris is looking to solve the problem of reimbursement and cash flow optimization for its diagnostic tests, including its flagship test NavDx, by hiring a Reimbursement Supervisor - Back End to oversee post-submission reimbursement activities.
Requirements
- Experience with Xifin, Quadax, or Telcor preferred
- Strong understanding of medical benefit structures, including Federal, State, PPO, HMO, and indemnity plans
- Working knowledge of CPT, ICD-10, and HCPCS coding, as well as LCD/NCD coverage and reimbursement guidelines
- Demonstrated ability to identify process gaps, improve workflows, and ensure follow-through
- Strong troubleshooting, organizational, and time-management skills
- Ability to adapt to evolving business needs
- Self-starter with the ability to work independently while supervising others
Responsibilities
- Supervise, coach, and train appeals and back-end reimbursement specialists; monitor daily workflows and productivity to ensure adherence to procedures and quality standards
- Oversee claims follow-up, denials management, and appeals processes across all payer types
- Serve as an escalation point for complex billing issues, payer disputes, and escalated patient or provider inquiries
- Partner with internal teams and the outsourced RCM vendor to resolve discrepancies and improve reimbursement outcomes
- Assist in developing, documenting, and refining back-end reimbursement policies and procedures
- Ensure compliance with all applicable billing regulations and company policies, including HIPAA; conduct audits to identify trends, errors, and improvement opportunities
- Leverage systems, tools, and vendor resources to support back-end reimbursement activities
Other
- 4+ years of experience in reimbursement or revenue cycle management within a diagnostics company, laboratory, or commercial payer environment
- Bachelor’s degree or equivalent experience
- Prior experience supervising or leading a reimbursement or appeals team
- Excellent verbal and written communication skills with a strong customer service mindset
- Travel requirement: up to 5%
