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Supervisor, Prior Authorizations

职能支持限定地区(需当地身份)
公司Natera
薪资未公开
工作地点US Remote
地域资格限定地区(需当地身份)
时区要求无特别要求
用工类型未标注
发布时间今天
数据来源Greenhouse
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监督员,先发授权工作总结 在纳特拉的 facturation operations 部门内支持先发授權功能团队日常运营和表现负责。该职位提供了直接操作监督先发授予拒绝与上诉,PA360和 PA 不匹配团队,包括国内和离岸雇员。监督员负责确保及时和准确地解决事先授权问题,管理团队生产力和质量,监测付款人要求,推动支持授权合规并最大限度地减少退还延误的运营改进。这一角色与内部利益相关者和外部团队密切合作,以解决升级的问题,确定过程效率低下以及优化事先授權工作流程。关键责任 · 监督先前授权拒绝和上诉,PA360和 PA 不匹配团队的日常运营,确保有效的工作流程管理,及时解决案例以及遵守部门绩效标准。· 为国内和海外团队成员提供日常领导,教练和绩效管理,确保整个团队的过程一致性,质量和生产力。· 对已建立的 KPI 进行团队表现监测,包括生产力,转型时间,案件解决率,质量,后载管理和其他操作指标。· 监督审查,调查和解决先前授权拒绝情况,包括调整上诉,确定拒绝趋势以及实施纠正措施以减少反复出现的问题。·确保及时识别,调查和处理可能影响申请处理或退款的先前授權差异,不匹配和其他授权相关问题。· 监控工作队列,案例量和老龄化库存,以确保适当的工作负载分配,及时跟踪和解决未完成的授权案件。· 作为复杂的预先授权问题,付款人纠纷,授权差异和其他需要进一步调查或跨职能协调的运营挑战的升级点。· 与内部团队合作,包括结算,保险验证,拒绝和上诉等收入周期功能,解决与授权相关的问题。

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Supervisor, Prior Authorization

Job Summary

The Supervisor, Prior Authorization is responsible for overseeing the daily operations and performance of teams supporting the Prior Authorization function within Natera's Billing Operations department. This position provides direct operational oversight of the Prior Authorization Denials & Appeals, PA360, and PA Mismatch teams, including both domestic and offshore employees.

The Supervisor is responsible for ensuring timely and accurate resolution of prior authorization issues, managing team productivity and quality, monitoring payer requirements, and driving operational improvements that support authorization compliance and minimize reimbursement delays. This role partners closely with internal stakeholders and external teams to resolve escalated issues, identify process inefficiencies, and optimize prior authorization workflows.

Key Responsibilities

  • Oversee the daily operations of the Prior Authorization Denials & Appeals, PA360, and PA Mismatch teams, ensuring efficient workflow management, timely case resolution, and adherence to departmental performance standards.
  • Provide day-to-day leadership, coaching, and performance management for both domestic and offshore team members, ensuring consistency in processes, quality, and productivity across teams.
  • Monitor team performance against established KPIs, including productivity, turnaround times, case resolution rates, quality, backlog management, and other operational metrics.
  • Oversee the review, investigation, and resolution of prior authorization denials, including coordination of appeals, identification of denial trends, and implementation of corrective actions to reduce recurring issues.
  • Ensure timely identification, investigation, and resolution of prior authorization discrepancies, mismatches, and other authorization-related issues that may impact claim processing or reimbursement.
  • Monitor work queues, case volumes, and aging inventory to ensure appropriate workload distribution, timely follow-up, and resolution of outstanding authorization cases.
  • Serve as an escalation point for complex prior authorization issues, payer disputes, authorization discrepancies, and other operational challenges requiring additional investigation or cross-functional coordination.
  • Collaborate with internal teams, including Billing, Insurance Verification, Denials & Appeals, and other Revenue Cycle functions, to resolve authorization-related issues and improve end-to-end billing workflows.
  • Partner with offshore team leads and operational stakeholders to ensure alignment on workflows, performance expectations, training, quality standards, and escalation procedures.
  • Identify trends and root causes contributing to prior authorization denials, authorization mismatches, processing delays, and other operational inefficiencies; recommend and implement process improvements.
  • Ensure team adherence to payer-specific authorization requirements, internal policies and procedures, documentation standards, and applicable healthcare regulations.
  • Conduct regular quality reviews and audits to ensure accuracy, completeness, and compliance with established prior authorization processes and payer guidelines.
  • Prepare, analyze, and communicate operational performance reports, identifying trends, areas of concern, and opportunities to improve team efficiency and authorization outcomes.
  • Support the development, implementation, and maintenance of standardized workflows, training materials, and standard operating procedures (SOPs) across assigned teams.
  • Participate in hiring, onboarding, training, employee development, and performance evaluations to build and maintain a high-performing team.
  • Foster a collaborative, accountable, and continuous-improvement-focused team environment that supports operational excellence and departmental objectives.

Qualifications

  • Associate's or Bachelor's degree in Healthcare Administration, Business, Finance, or a related field, or equivalent professional experience.
  • 3+ years of healthcare revenue cycle experience, with demonstrated experience in prior authorization, insurance verification, authorization denials, appeals, or related payer authorization processes.
  • 1+ year of experience in a supervisory, team lead, or comparable leadership role.
  • Strong understanding of prior authorization workflows, payer authorization requirements, denial and appeal processes, and the relationship between authorization activities, claims processing, and reimbursement.
  • Working knowledge of commercial and government payer policies, medical necessity requirements, and healthcare billing practices.
  • Experience monitoring operational KPIs, managing work queues, identifying performance trends, and implementing process improvements.
  • Strong analytical, organizational, and problem-solving skills, with the ability to investigate complex issues and develop actionable solutions.
  • Excellent communication and interpersonal skills, with demonstrated ability to collaborate across departments and provide effective coaching and feedback.
  • Ability to manage competing priorities, meet deadlines, and lead teams in a fast-paced, high-volume operational environment.

Preferred Qualifications

  • Experience supervising prior authorization teams or related revenue cycle functions in a high-volume healthcare, diagnostic laboratory, or specialty testing environment.
  • Experience overseeing geographically distributed teams, including offshore or outsourced operational teams.
  • Familiarity with prior authorization requirements and payer policies specific to diagnostic testing, molecular diagnostics, or genetic testing.
  • Experience managing prior authorization denials, appeals, authorization discrepancies, or payer-related escalations.
  • Proficiency with revenue cycle management systems, payer portals, reporting tools, and Microsoft Excel.
  • Experience developing and implementing process improvements, standardized workflows, and quality assurance initiatives.
  • Healthcare revenue cycle certification (e.g., CRCS, CRCP) or related professional certification.

The pay range is listed and actual compensation packages are based on a wide array of factors unique to each candidate, including but not limited to skill set, years & depth of experience, certifications and specific office location. This may differ in other locations due to cost of labor considerations.
Remote USA
$69,200—$85,000 USD

OUR OPPORTUNITY

Natera™ is a global leader in cell-free DNA (cfDNA) testing, dedicated to oncology, women’s health, and organ health. Our aim is to make personalized genetic testing and diagnostics part of the standard of care to protect health and enable earlier and more targeted interventions that lead to longer, healthier lives.

The Natera team consists of highly dedicated statisticians, geneticists, doctors, laboratory scientists, business professionals, software engineers and many other professionals from world-class institutions, who care deeply for our work and each other. When you join Natera, you’ll work hard and grow quickly. Working alongside the elite of the industry, you’ll be stretched and challenged, and take pride in being part of a company that is changing the landscape of genetic disease management.

WHAT WE OFFER

Competitive Benefits - Employee benefits include comprehensive medical, dental, vision, life and disability plans for eligible employees and their dependents. Additionally, Natera employees and their immediate families receive free testing in addition to fertility care benefits. Other benefits include pregnancy and baby bonding leave, 401k benefits, commuter benefits and much more. We also offer a generous employee referral program!

For more information, visit www.natera.com.

Natera is proud to be an Equal Opportunity Employer. We are committed to ensuring a diverse and inclusive workplace environment, and welcome people of different backgrounds, experiences, abilities and perspectives. Inclusive collaboration benefits our employees, our community and our patients, and is critical to our mission of changing the management of disease worldwide.

All qualified applicants are encouraged to apply, and will be considered without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, age, veteran status, disability or any other legally protected status. We also consider qualified applicants regardless of criminal histories, consistent with applicable laws.

If you are based in California, we encourage you to read this important information for California residents.

Link: https://www.natera.com/notice-of-data-collection-california-residents/

Please be advised that Natera will reach out to candidates with a @natera.com email domain ONLY. Email communications from all other domain names are not from Natera or its employees and are fraudulent. Natera does not request interviews via text messages and does not ask for personal information until a candidate has engaged with the company and has spoken to a recruiter and the hiring team. Natera takes cyber crimes seriously, and will collaborate with law enforcement authorities to prosecute any related cyber crimes.

For more information:
- BBB announcement on job scams 
- FBI Cyber Crime resource page

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