Manager, Prior Authorizations

Summary

Join Natera as a Prior Authorization Lead, managing a team and overseeing the prior authorization function within billing and collections. You will supervise staff, handle performance evaluations, and collaborate with various departments to optimize prior authorization workflows. Responsibilities include analyzing prior authorization outcomes, ensuring compliance with payor requirements, and representing organizational projects. The ideal candidate possesses a Bachelor's degree, extensive billing and coding knowledge, and at least 5 years of relevant management experience in a laboratory setting. 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 required
• Extensive knowledge of payor reimbursement, billing, coding and compliance regulations is required
• Training in fields such as business administration, accountancy, sales, marketing, computer sciences or similar vocations
• Normally requires a minimum of two (2) years directly related and progressively responsible experience
• Ability to perform complex analysis and discuss with upper management
• Skilled in Microsoft Office: Word and Excel
• Ability to communicate effectively both orally and in writing
• Strong interpersonal skills
• Strong organizational skills, including attention to detail
• Knowledge of payer eligibility and benefits
• Health care research and analysis skills sufficient to support payer research healthcare policy library and state management
• Ability to resolve associate issues effectively and efficiently

Responsibilities

• Manages large teams, including supervision of staff for a pre-certification denials and appeals team
• Assists with hiring, disciplinary actions, and performance evaluations
• Provides department orientation and ongoing training for all in/direct reports
• Directs self and others in areas of responsibility such as research, appeals, pre-certification, payor policy and eligibility
• Liaison with internal departments to promote ongoing communication, and collaboration on cross functional projects related to prior authorization
• Analyze prior authorization outcomes including payor reimbursement exception reporting, appeal follow up analysis and denials management
• Utilize billing expertise in the system to investigate and analyze insurance payor requirements for prior authorization, ensuring compliance and streamlined approvals
• Partner cross-functionally with Market Access, Sales, Billing Strategy, and Clinical teams to ensure alignment on prior authorization workflows, payer policy adherence, and reimbursement optimization strategies, with the shared goal of improving overall patient access
• Represent organizational projects and assist management with follow-through and implementation of initiatives
• Monitors and validates adherence to Policies and Procedures, auditing as necessary
• Monitors and evaluates employee productivity and performance to goal
• Builds employee morale, motivation and loyalty by fostering positive working relationships
• This role works with PHI on a regular basis both in paper and electronic form and has access to various technologies to access PHI (paper and electronic) in order to perform the job

Preferred Qualifications

Minimum of 5 years of experience in managing a high volume, fast growing billing office within the laboratory setting is preferred

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!