Associate Revenue Cycle Analyst – Prior Authorizations
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Job Description
Associate Revenue Cycle Analyst responsible for ensuring data integrity and operational excellence in Prior Authorizations at Natera, a leader in genetic testing.
Responsibilities:
- Inventory Diagnostic & Management: Actively monitors the PA work to identify inventory volume, aging trends, and 'stuck' requests. Determines necessary interventions to move files forward and maintain SLA compliance.
- PA Submission Integrity: Serves as the operational analyst for the submission workflow, ensuring that all upstream data is complete and accurate before submission.
- Cross-Functional Collaboration: Partners with Market Access to align on payor policies and works with Claims/Denials teams to bridge the gap between authorization feedback and actual payment outcomes.
- Anomaly Investigation: Performs deep-dive investigations into payer and vendor discrepancies and recommends system logic or workflow adjustments.
- Requirements & Documentation Management: Identifies and documents specific PA job requirements to ensure submissions are "right the first time."
- Root-Cause Trend Analysis: Conducts analysis on PA delays or submission failures, presenting actionable findings to leadership to drive continuous performance improvement.
- Workflow & Tracking Development: Assists in building and refining tracking tools and standardized workflows for the PA lifecycle.
- Vendor Monitoring: Reviews vendor performance and output, ensuring external partners accurately process actions and adhere to the organization’s high standards for reimbursement accuracy.
- KPI Reporting: Tracks and reports on key metrics, including Submission Turnaround Time (TAT), inventory 'bottleneck' age, vendor error rates, etc.
- Strategic Communication: Acts as a liaison for management to explain complex operational trends, system glitches, or payer-behavior shifts affecting the revenue cycle.
- Knowledge Sharing: Serves as a technical resource for internal teams regarding PA submission nuances and best practices for process improvement.
Requirements:
- Education: Bachelor’s Degree in Business, Healthcare Administration, or a related field (or equivalent professional experience).
- Experience: 2–4 years of experience in healthcare revenue cycle, with a specific focus on prior authorization analysis, medical billing, or inventory management.
- Inventory Mastery: Advanced ability to manage high-volume inventory and identify specific points of failure or stagnation within a process.
- Technical Problem Solving: Strong critical thinking skills to troubleshoot logic errors and discrepancies between payor responses and internal routing rules.
- Data Proficiency: High proficiency in Microsoft Excel/Google Sheets (VLOOKUPs, Pivot Tables, Data Visualization).
- Collaborative Mindset: Ability to influence and work effectively across diverse teams.
- Analytical Communication: Ability to translate complex data into clear, concise reports for stakeholders at all levels.
- Nuanced Accuracy: Deep understanding of medical terminology and procedure coding as it relates to payor-specific submission requirements.
- Discretion: Strict adherence to HIPAA and confidentiality protocols regarding sensitive patient and financial data.
Benefits:
- Competitive 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!
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