Prior Authorization Lead - Revenue Cycle (Remote)

Natera; United States; Remote; USD 62,000 - 85,000; Full time

Benefits offered by this job

Medical, dental, vision, life and DIS/

Fertility care benefits

401k and commuter benefits

Employee referral program

Job summary

Natera is seeking a Supervisor, Prior Authorization to lead the daily operations of the Prior Authorization teams within Billing Operations, including domestic and offshore staff. The role focuses on timely and accurate issue resolution, productivity, quality, and adherence to payer requirements.

This leadership position collaborates with internal stakeholders to resolve escalations, optimize workflows, and minimize reimbursement delays in a remote US environment.

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.

Responsibilities

• Oversee the daily operations of teams responsible for the full Prior Authorization function (submissions, denials and appeals, etc.) 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.

Skills

Leadership

Coaching & feedback

Analytical skills

Communication skills

Prior authorization knowledge

Problem-solving

Education

Bachelor's degree or higher

Tools

Excel

RCM systems

Payer portals

Job description

Natera is seeking a Supervisor, Prior Authorization to lead the daily operations of the Prior Authorization teams within Billing Operations, including domestic and offshore staff. The role focuses on timely and accurate issue resolution, productivity, quality, and adherence to payer requirements.

This leadership position collaborates with internal stakeholders to resolve escalations, optimize workflows, and minimize reimbursement delays in a remote US environment.