Manager, Prior Authorizations

Summary

Join Natera as a Prior Authorization Manager and lead a remote team of specialists, ensuring they meet key performance indicators. You will oversee daily operations, provide training, and collaborate with internal departments. Responsibilities include analyzing prior authorization outcomes, managing the department's workflow, and ensuring compliance. This role requires a Bachelor's degree or equivalent experience, extensive knowledge of billing and compliance, and proven experience managing a high-volume billing team. Natera offers competitive benefits, including comprehensive medical, dental, vision, life, and disability plans, as well as free testing for employees and their families.

Requirements

• Bachelor’s Degree in related field or equivalent years of relevant experience
• Minimum of 5 years of experience in managing a high volume, fast growing billing team; within the laboratory setting is preferred
• Extensive knowledge of reimbursement, billing, coding and compliance regulations
• Proficiency in utilizing Microsoft Excel and reporting functions (Pivot tables, VLOOKUPS, etc.)
• Experience in training in fields such as business administration, accountancy, sales, marketing, computer sciences or similar vocations
• Experienced in the supervision of staff of a pre-certification department
• Experience with directing self and others in areas of responsibility such as research, appeals, order entry, pre-certification and eligibility
• Two (2) years of experience in prior authorization and insurance billing
• Ability to perform complex analysis and discuss with upper management
• Ability to communicate effectively both orally and in writing
• Strong interpersonal skills and organizational skills, including attention to detail
• Knowledge of payer eligibility and benefits
• Experience in healthcare research and analysis skills sufficient to support payer research healthcare policy library and state management
• Ability to resolve associate issues effectively and efficiently

Responsibilities

• Manage a large remote team of Prior Authorization Specialists and ensure they meet production metrics and KPIs
• Assist with feedback for hiring, discipline and performance evaluations
• Provide department orientation and ongoing training for all in/direct reports
• Act as a liaison with internal departments to promote ongoing communication, and collaboration on cross functional projects related to prior authorization
• Analyze prior authorization outcomes from all sources, including carrier reimbursement exception reporting and follow up pending prior authorization analysis and denials management
• Represent organizational projects and assist management with follow-through and implementation of initiatives
• Manage all aspects of the prior authorization department including the timely, accurate submission and collection of all patient and customer accounts
• Work with across departments to manage the entire process from insurance verification to final collection
• Responsible for the timely accurate submission of all prior authorizations for service to the responsible payer
• Ensure that all payers needing prior authorization are set up correctly within the software system
• Monitor and validate adherence to Policies and Procedures, auditing as necessary. Monitor and evaluate employee productivity and performance to goal
• Build employee morale, motivation and loyalty by fostering positive working relationships

Benefits

• Comprehensive medical, dental, vision, life and disability plans for eligible employees and their dependents
• Free testing in addition to fertility care benefits
• Pregnancy and baby bonding leave
• 401k benefits
• Commuter benefits
• Generous employee referral program