Manager, Prior Authorizations
Natera
full-time
Posted on:
Location Type: Remote
Location: Remote • 🇺🇸 United States
Visit company websiteSalary
💰 $105,400 - $120,000 per year
Job Level
Mid-LevelSenior
About the role
- Oversee daily operations of the Prior Authorization Submissions team, ensuring that all requests are processed accurately and within defined turnaround times (TAT).
- Monitor and optimize team productivity and quality performance, ensuring adherence to departmental KPIs (≥95% accuracy; daily volume targets).
- Manage queue prioritization, workload balancing, and escalation handling for complex or high-priority cases.
- Develop and maintain standard operating procedures (SOPs) for submission workflows, ensuring alignment with payor-specific requirements and regulatory compliance (HIPAA, PHI).
- Collaborate with internal stakeholders to minimize downstream claim denials and ensure end-to-end process integrity.
- Recruit, train, and develop a team of Prior Authorization Supervisors and Specialists; provide coaching, feedback, and performance evaluations.
- Track and analyze team performance data, including submission volumes, approval rates, and denials.
Requirements
- Bachelor’s degree in Healthcare Administration, Business, or related field, or equal years of relevant professional experience.
- 5+ years of experience in Revenue Cycle Management or healthcare operations, with at least 2 years in prior authorization management or payor policy leadership.
- Strong understanding of medical billing workflows, payor authorization systems, and revenue cycle operations.
- Expertise in medical necessity criteria and payor-specific prior authorization requirements.
- Proven ability to analyze operational data, identify performance gaps, and implement corrective actions.
- Experience working with Business Process Outsourcing (BPO) teams.
- Proficiency with Google Workspace and other RCM workflow tools.
Benefits
- Health insurance
- 401k benefits
- Paid time off
- Commuter benefits
- Fertility care benefits
- Pregnancy and baby bonding leave
- Free testing for employees and their direct families
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
revenue cycle managementmedical billing workflowspayor authorization systemsmedical necessity criteriaoperational data analysisperformance gap identificationcorrective actions implementationprior authorization managementpayor policy leadership
Soft skills
team managementcoachingfeedbackperformance evaluationscollaborationworkload balancingqueue prioritizationescalation handlingproductivity optimization