Supervisor, Prior Authorizations
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Job Description
Supervising prior authorization teams at Natera, a cell-free DNA testing and genetic diagnostics company. Managing denials, appeals, payer compliance, KPIs, and workflow improvements.
Responsibilities:
- Oversee daily operations of the Prior Authorization Denials & Appeals, PA360, and PA Mismatch teams
- Provide leadership, coaching, and performance management for domestic and offshore team members
- Monitor KPIs including productivity, turnaround times, case resolution rates, quality, and backlog management
- Oversee investigation and resolution of prior authorization denials, appeals, discrepancies, and mismatches
- Monitor work queues, case volumes, and aging inventory
- Serve as an escalation point for complex authorization issues and payer disputes
- Collaborate with Billing, Insurance Verification, Denials & Appeals, and other Revenue Cycle teams
- Partner with offshore team leads and operational stakeholders on workflows, training, quality, and escalations
- Identify root causes and implement process improvements
- Ensure adherence to payer requirements, internal policies, documentation standards, and healthcare regulations
- Conduct quality reviews and audits
- Prepare, analyze, and communicate operational performance reports
- Support standardized workflows, training materials, and SOPs
- Participate in hiring, onboarding, training, employee development, and performance evaluations
- Foster a collaborative, accountable, continuous-improvement-focused team environment
Requirements:
- 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, including 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
- Excellent communication and interpersonal skills, including coaching and feedback
- Ability to manage competing priorities, meet deadlines, and lead teams in a fast-paced, high-volume operational environment
- Experience supervising prior authorization teams or related revenue cycle functions in a high-volume healthcare, diagnostic laboratory, or specialty testing environment
- Experience overseeing geographically distributed teams, including offshore or outsourced operational teams
- Familiarity with prior authorization requirements and payer policies specific to diagnostic testing, molecular diagnostics, or genetic testing
- Experience managing prior authorization denials, appeals, authorization discrepancies, or payer-related escalations
- Proficiency with revenue cycle management systems, payer portals, reporting tools, and Microsoft Excel
- Experience developing and implementing process improvements, standardized workflows, and quality assurance initiatives
- Healthcare revenue cycle certification (e.g., CRCS, CRCP) or related professional certification
Benefits:
- Comprehensive medical, dental, vision, life and disability plans for eligible employees and their dependents
- Free testing for employees and their immediate families
- Fertility care benefits
- Pregnancy and baby bonding leave
- 401(k) benefits
- Commuter benefits
- Employee referral program
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