Prior Authorization Knowledge & Policy Specialist

Summary

Join Natera's Authorization Resource Center (ARC) as a Prior Authorization Knowledge & Policy Specialist. You will be responsible for gathering prior authorization (PA) requirements from insurance plans, creating clear resources and job aids, and supporting internal teams. This role involves contacting payers, documenting findings, serving as a subject matter expert on authorization criteria, developing step-by-step guides, maintaining a knowledge library, managing Jira tickets, identifying process improvements, training stakeholders, and adapting to a changing environment. You will play a key role in shaping a new function impacting patient access and revenue integrity. The ideal candidate possesses prior authorization expertise, strong communication and documentation skills, a process-improvement mindset, and familiarity with technical tools. This position offers a competitive salary and benefits package.

Requirements

• Prior Authorization Expertise – 2 + years in PA advocacy, revenue-cycle, or insurance verification (hospital, laboratory, or health-tech setting)
• Payer-Facing Communication – Comfortable calling payer reps to clarify requirements and escalating when necessary
• Documentation Strength – Proven ability to write concise, step-by-step instructions and policy summaries
• Process-Improvement Mindset – Experience mapping workflows, spotting inefficiencies, and driving corrective action
• Technical Tools – Familiarity with Jira (or similar ticketing), MS Office (advanced Excel a plus for code/policy tracking), and common payer portals (e.g., Availity)
• Adaptability & Self-Direction – Demonstrated success in unstructured, fast-changing environments; self-starter who needs minimal oversight
• Education – Bachelor’s degree or equivalent combination of training and hands-on PA/RCM experience

Responsibilities

• Contact payers to confirm PA requirements, covered codes, and portal workflows
• Document findings in standard templates; update configurations in billing/eligibility systems
• Serve as a subject-matter expert on test-specific authorization criteria and payer nuances
• Create step-by-step guides (job aids) for submitting and obtaining PAs through Availity and other payer portals
• Maintain a searchable knowledge library covering “which tests require authorization” and “how to configure system flags.”
• Monitor and respond to information-request tickets from clinical, billing, and customer-service teams
• Prioritize, resolve, and close tickets, ensuring accurate documentation and timely SLAs
• Identify recurring pain points; propose workflow changes to reduce denials and turnaround time
• Train cross-functional stakeholders on new PA policies, resources, and best practices
• Contribute to ARC team stand-ups and retrospectives, sharing insights and lessons learned
• Thrive in a “build-as-we-go” setting—adapt quickly as payer rules, internal processes, and team structures evolve
• Proactively surface gaps in knowledge content and help define new processes as the ARC matures

Preferred Qualifications

• Prior experience building knowledge bases, SOPs, or job-aid libraries from the ground up
• Exposure to automation/AI solutions in revenue-cycle or health-tech workflows
• Understanding of CPT/HCPCS coding and its impact on authorization requirements
• Strong presentation skills for educating diverse internal audiences

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!