Supervisor, Prior Authorizations

Natera

2d • $69,200 - $85,000 • Remote

About The Position

The Supervisor, Prior Authorization oversees daily operations and performance for teams supporting the Prior Authorization function within Natera’s Billing Operations department. The role provides operational oversight of the Prior Authorization Denials & Appeals, PA360, and PA Mismatch teams, including domestic and offshore employees.

The Supervisor ensures timely and accurate resolution of authorization issues, manages team productivity and quality, monitors payer requirements, and improves operations to support authorization compliance and minimize reimbursement delays. The position works with internal stakeholders and external teams to resolve escalated issues, address process inefficiencies, and optimize workflows.

Requirements

• Associate’s or Bachelor’s degree in Healthcare Administration, Business, Finance, or a related field, or equivalent professional experience.
• At least 3 years of healthcare revenue cycle experience, including prior authorization, insurance verification, authorization denials, appeals, or related payer authorization processes.
• At least 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 how authorization activities relate to 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, including the ability to investigate complex issues and develop actionable solutions.
• Excellent communication and interpersonal skills, including the ability to collaborate across departments and provide coaching and feedback.
• Ability to manage competing priorities, meet deadlines, and lead teams in a fast-paced, high-volume operational environment.

Nice To Haves

• 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 for 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 a related professional certification.

Responsibilities

• Oversee daily operations of the Prior Authorization Denials & Appeals, PA360, and PA Mismatch teams, ensuring efficient workflows, timely case resolution, and adherence to performance standards.
• Lead, coach, and manage the performance of domestic and offshore team members, promoting consistency in processes, quality, and productivity.
• Monitor team performance against KPIs, including productivity, turnaround times, resolution rates, quality, and backlog management.
• Oversee investigation and resolution of prior authorization denials, coordinate appeals, identify denial trends, and implement corrective actions.
• Ensure timely investigation and resolution of prior authorization discrepancies, mismatches, and other issues that may affect claims or reimbursement.
• Monitor work queues, case volumes, and aging inventory; ensure workload is distributed appropriately and cases receive timely follow-up.
• Act as an escalation point for complex authorization issues, payer disputes, discrepancies, and operational challenges requiring investigation or cross-functional coordination.
• Collaborate with Billing, Insurance Verification, Denials & Appeals, and other Revenue Cycle teams to resolve authorization issues and improve billing workflows.
• Partner with offshore team leads and operational stakeholders on workflows, performance expectations, training, quality standards, and escalations.
• Identify trends and root causes behind denials, mismatches, processing delays, and inefficiencies; recommend and implement improvements.
• Ensure adherence to payer-specific requirements, internal policies and procedures, documentation standards, and applicable healthcare regulations.
• Conduct quality reviews and audits to verify accuracy, completeness, and compliance with authorization processes and payer guidelines.
• Prepare, analyze, and communicate operational performance reports, highlighting trends, concerns, and opportunities for improvement.
• Support the development and maintenance of standardized workflows, training materials, and standard operating procedures.
• Participate in hiring, onboarding, training, employee development, and performance evaluations.
• Foster a collaborative, accountable, and continuous-improvement-focused team environment.

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.

What This Job Offers

• Job Type: Full-time
• Career Level: Manager
• Education Level: Associate degree