Remote Prior Authorization Operations Lead

Natera, Inc.; United States; Remote; USD 69,000 - 85,000; Full time

Job summary

Natera, Inc. is seeking a Supervisor, Prior Authorization to oversee the Prior Authorization Denials & Appeals, PA360, and PA Mismatch teams in the Billing Operations group.

This role will manage domestic and offshore staff, ensure timely case resolution, and drive improvements to payer compliance and reimbursement timelines. The ideal candidate has 3+ years in healthcare revenue cycle with leadership experience and a strong grasp of PA workflows, denials, and appeals.

Qualifications

• Associates or Bachelor's degree in Healthcare Administration, Business, Finance, or related field, or equivalent experience.
• 3+ years in healthcare revenue cycle with prior authorization, insurance verification, denials or appeals.
• 1+ year in supervisory, team lead, or leadership role.
• Strong understanding of prior authorization workflows, payer requirements, denial/appeal processes and reimbursement relationships.
• Knowledge of commercial and government payer policies, medical necessity, and healthcare billing practices.
• Experience monitoring KPIs, queues, trends, and implementing process improvements.
• Analytical, organizational, and problem-solving skills with ability to resolve complex issues.
• Excellent communication and collaboration across departments with coaching abilities.
• Ability to manage competing priorities in a fast-paced environment.

Responsibilities

• Oversee daily operations of Prior Authorization Denials & Appeals, PA360, and PA Mismatch teams across domestic and offshore staff.
• Provide leadership, coaching, and performance management for all team members.
• Monitor KPIs including productivity, turnaround times, case resolution, quality, backlog and other metrics.
• Lead review and resolution of denials, coordinate appeals, identify trends and implement corrective actions.
• Ensure timely identification and resolution of authorization discrepancies impacting processing or reimbursement.
• Manage work queues, case volumes, and aging inventory to balance workload and timely resolutions.
• Serve as escalation point for complex PA issues requiring cross-functional coordination.
• Collaborate with Billing, Insurance Verification, Denials & Appeals, and other Revenue Cycle teams to optimize workflows.
• Coordinate with offshore leads to align workflows, training, and escalation procedures.
• Identify root causes of denials and mismatches and drive process improvements.
• Ensure adherence to payer requirements, internal policies, and regulatory guidelines.
• Prepare and communicate performance reports highlighting trends and areas for improvement.
• Support development of standardized SOPs and training materials across teams.
• Participate in hiring, onboarding, and performance evaluations to maintain a high-performing team.
• Foster a collaborative, accountable, and continuous-improvement environment.

Skills

Team leadership

KPIs & metrics

Cross-functional collaboration

Education

Bachelor's degree (Healthcare Admin/Business/Finance or related)

Tools

Microsoft Excel

Job description

Natera, Inc. is seeking a Supervisor, Prior Authorization to oversee the Prior Authorization Denials & Appeals, PA360, and PA Mismatch teams in the Billing Operations group.

This role will manage domestic and offshore staff, ensure timely case resolution, and drive improvements to payer compliance and reimbursement timelines. The ideal candidate has 3+ years in healthcare revenue cycle with leadership experience and a strong grasp of PA workflows, denials, and appeals.