EDI & Claims Operations Analyst

Summary

Natera is a global leader in cell-free DNA testing focused on oncology, women’s health, and organ health. The company is seeking an EDI & Claims Operations Analyst to manage claim status processes, investigate acceptance and rejection issues, and improve healthcare billing workflows through analytics, automation, and cross-functional collaboration.

Responsibilities

• Monitor claim status activity across clearinghouses and payer systems to ensure claims are successfully transmitted, received, and processed
• Analyze large claim populations to identify trends, bottlenecks, acceptance issues, and payer-specific workflow challenges
• Investigate rejected, unacknowledged, delayed, or "stuck" claims and determine root causes
• Partner with Billing Operations, Insurance Verification, Denials Management, Coding, Configuration, Engineering, and Automation teams to resolve claim processing issues
• Identify opportunities to automate manual claim status workflows and improve operational efficiency
• Serve as a subject matter expert on clearinghouse operations, payer connectivity, claim submission workflows, EDI transactions, and claim status processes
• Research payer-specific requirements, acceptance rules, rejection patterns, and status behaviors
• Develop recommendations for workflow improvements that increase claim acceptance rates and reduce downstream denials
• Track and trend claim status performance metrics and communicate findings to operational leadership
• Support implementation and optimization of automation solutions related to claim status management and payer communications
• Create process documentation, job aids, and operational guidance to support standardized workflows
• Assist with escalation management and complex claim routing decisions
• Collaborate with internal and external stakeholders to identify systemic issues and implement sustainable corrective actions

Skills

• Bachelor's degree or equivalent combination of education and experience
• 4+ years of healthcare revenue cycle experience
• Experience working with claim submission, claim status, claim acceptance/rejection management, or EDI operations
• Strong understanding of healthcare claims workflows and payer processing
• Experience researching and resolving claim transmission, acceptance, or rejection issues
• Advanced Microsoft Excel or Google Sheets skills, including data analysis and reporting
• Strong analytical, investigative, and problem-solving abilities
• Ability to work independently and drive issues to resolution across multiple teams
• Excellent communication and stakeholder management skills
• Experience working with clearinghouses such as Change Healthcare, Waystar, Experian, Availity, or similar platforms
• Understanding of EDI healthcare transactions, including 837 claims, 835 remittances, and claim status transactions
• Experience supporting healthcare automation initiatives or workflow optimization projects
• Experience using Snowflake, Power BI, Tableau, SQL, or similar analytical tools
• Familiarity with payer configuration, payer enrollment, or electronic claims routing
• Experience working in high-volume healthcare billing environments

Qualifications

Must Haves

• Bachelor's degree or equivalent combination of education and experience
• 4+ years of healthcare revenue cycle experience
• Experience working with claim submission, claim status, claim acceptance/rejection management, or EDI operations
• Strong understanding of healthcare claims workflows and payer processing
• Experience researching and resolving claim transmission, acceptance, or rejection issues
• Advanced Microsoft Excel or Google Sheets skills, including data analysis and reporting
• Strong analytical, investigative, and problem-solving abilities
• Ability to work independently and drive issues to resolution across multiple teams
• Excellent communication and stakeholder management skills

Nice to Haves

• Experience working with clearinghouses such as Change Healthcare, Waystar, Experian, Availity, or similar platforms
• Understanding of EDI healthcare transactions, including 837 claims, 835 remittances, and claim status transactions
• Experience supporting healthcare automation initiatives or workflow optimization projects
• Experience using Snowflake, Power BI, Tableau, SQL, or similar analytical tools
• Familiarity with payer configuration, payer enrollment, or electronic claims routing
• Experience working in high-volume healthcare billing environments

Benefits

• Comprehensive medical, dental, vision, life and disability plans for eligible employees and their dependents.
• Natera employees and their immediate families receive free testing.
• Fertility care benefits.
• Pregnancy and baby bonding leave.
• 401k benefits.
• Commuter benefits.
• Generous employee referral program.