Reimbursement Supervisor Back End

About Us

Would you like to be part of a fast-growing team that believes no one should have to succumb to viral-mediated cancers Naveris a commercial stage precision oncology diagnostics company with facilities in Boston MA and Durham NC is looking for a Reimbursement Supervisor - Back End team member to help us advance our mission of developing and delivering novel diagnostics that transform cancer detection and improve patient outcomes. Our flagship test NavDx is a breakthrough blood-based DNA test for HPV cancers clinically proven and already trusted by thousands of physicians and institutions across the U.S.

Opportunity

We are looking for a conscientious knowledgeable Reimbursement Supervisor Back End to join our team and oversee post-submission reimbursement activities. While Naveris partners with an outsourced RCM vendor this role provides hands-on oversight of claims follow-up denials management and appeals to ensure accurate reimbursement across Medicare Medicaid and commercial payers. This position plays a key role in driving timely resolution compliance and cash flow optimization.

Job Responsibilities

Reporting to the Manager Reimbursement & Appeals this role supports the Reimbursement department by supervising back-end reimbursement operations and staff. The Reimbursement Supervisor Back End is responsible for overseeing claims follow-up appeals workflows payer escalations and compliance to ensure timely and accurate reimbursement.

• 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
• Recommend process improvements to enhance efficiency productivity and cash flow
• Stay current on payer policies coding updates and federal/state regulations through ongoing education
• Communicate clearly with patients and providers regarding EOBs appeals status financial responsibility and reimbursement policies in escalated cases
• Critically assess complex situations and escalate to leadership when appropriate
• Maintain a strong understanding of the end-to-end reimbursement lifecycle and communicate effectively across teams
• Leverage systems tools and vendor resources to support back-end reimbursement activities
• Manage multiple priorities and operate with urgency in a fast-paced environment
• Fully remote role (U.S.-based) with occasional travel for trainings meetings or on-site presence at headquarters.
• Travel requirement: up to 5%.

Requirements

• 4 years of experience in reimbursement or revenue cycle management within a diagnostics company laboratory or commercial payer environment
• Bachelors degree or equivalent experience
• Prior experience supervising or leading a reimbursement or appeals team
• 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
• Excellent verbal and written communication skills with a strong customer service mindset
• 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

Compliance Responsibilities

Health Insurance Portability and Accountability Act (HIPAA) is a federal law that describes the national standards to protect sensitive patient health information from being disclosed without the patients consent or knowledge. All roles at Naveris require compliance with legal and regulatory requirements of HIPAA and acceptance and adherence to all policies and standards at Naveris. Personnel acknowledges they are personally responsible for reporting any suspected violations or abuse and are required to complete HIPAA training when joining the company.

Why Naveris

In addition to our great team and advanced medical technology we offer our employees competitive compensation work/life balance remote work opportunities and more!

Naveris is an Equal Opportunity Employer

Naveris is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. We dont just accept differences - we celebrate and support them. We do not discriminate in employment on the basis of race color religion sex (including pregnancy and gender identity) national origin political affiliation sexual orientation marital status disability genetic information age membership in an employee organization retaliation parental status military service or other non-merit factor.