Director, Billing and Reimbursement

Location: Remote, Hybrid, or On-Site in Boulder, Colorado, United States

About Our Company

Foresight Diagnostics is an early-stage, venture-backed molecular diagnostics company that is developing non-invasive cancer detection technologies to improve the lives of patients worldwide. Our portfolio of cell-free DNA based liquid biopsy tests are rooted in novel and proprietary methods developed at Stanford University. Our approach enables the earlier detection of smaller tumors, leading to more personalized and effective cancer treatment strategies for patients. We have deep expertise in molecular biology, bioinformatics, and Next Generation Sequencing (NGS), and maintain a dynamic, fast-paced work environment with significant opportunities for high-impact contribution and rapid professional growth. Foresight Diagnostics is headquartered in Boulder, Colorado.

About The Role

The Director, Billing & Reimbursement will lead the company’s diagnostic billing operations, ensuring efficient revenue cycle processes, compliance with payer policies, and optimization of reimbursement for ctDNA, minimal residual testing (MRD) testing. This position will oversee end-to-end billing operations including claims submission, denial management, payer contracting support, and revenue integrity. The ideal candidate will bring deep expertise in laboratory billing, coding, and payer relations within the molecular diagnostics or oncology testing space.

What You Will Do

Billing Operations & Revenue Cycle Management

• Oversee and manage all aspects of the billing process, including claims submission, coding, payment posting, and accounts receivable.

• Develop and implement best practices to maximize clean claim rates, reduce denials, and improve collection timelines.

• Ensure compliance with all regulatory requirements, including Medicare, Medicaid, and commercial payer billing policies.

• Optimize billing workflows, technology systems, and automation to improve efficiency and reduce errors.

Payer Relations & Reimbursement Optimization

• Collaborate with payers ensure proper coding, coverage, and reimbursement for MRD diagnostics.

• Support the Foresight market access team during contract negotiations with commercial payers and government programs to improve reimbursement rates and minimize claim denials.

• Monitor changes in payer policies and advocate for favorable reimbursement policies for MRD testing.

Compliance & Regulatory Adherence

• Ensure billing practices align with state and federal regulations, including CMS guidelines, HIPAA, and fraud prevention laws.

• Work closely with legal, compliance, and finance teams to mitigate billing risks and maintain accurate documentation.

• Lead internal billing audits and support external payer audits or reviews.

Team Leadership & Cross-Functional Collaboration

• Manage third party revenue cycle managers, ensuring performance to contract and driving successful billing outcomes.

• Manage and develop a high-performing billing team, including billing specialists, coders, and claims resolution staff.

• Partner with finance, market access, sales, and lab operations teams to ensure seamless revenue cycle operations.

• Provide training and ongoing education on billing policies and best practices for internal teams.

What You Will Bring

• Bachelor’s degree in healthcare administration, finance, business, or a related field (MBA or CPC certification preferred).

• Minimum of 7-10 years in laboratory billing, revenue cycle management, or payer contracting, with at least 3 years in a leadership role.

• Deep knowledge of molecular diagnostics billing, CPT coding, Medicare and commercial payer requirements, and prior authorization processes.

• Experience with laboratory information systems (LIS), electronic health record (EHR) billing, and revenue cycle management software.

• Strong analytical, problem-solving, and leadership skills.

• Ability to work cross-functionally and communicate complex billing matters effectively.

Compensation and Benefits

This role is hiring at an annual salary of $193,375 - $218,500 and is eligible for equity offerings. Foresight offers benefits including paid vacation, sick time, and parental leave (if applicable), alongside medical, dental, vision, life, disability coverage, flexible spending accounts, and a 401k with company match.

The application deadline for this position is April 30, 2025.

You will be working on interesting problems with extremely high impact. We promote the professional development of our employees and will encourage upward mobility within the company for high performing employees. Foresight Diagnostics is an equal opportunity employer. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.