96 applicants

Company

Original Job Post

Natera · 3 days ago

Program Manager, Prior Authorizations

United States

Full-time

Remote

Mid, Senior Level

5+ years exp

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Responsibilities

Track/monitor all cases requiring true prior authorization.

Create/provide weekly updates to leadership on all pending/processed cases.

Participate in submission, follow up, and performing necessary action on adverse decisions of prior authorization requests.

Provide financial and business analytics for decisions by organizational stakeholders.

Develop actionable roadmaps for improving workflows and processes.

Perform in-depth reviews/audits to identify issues/trends and create remediation plan(s).

Support management of projects to ensure successful and timely completion.

Support management in monitoring and tracking adherence of SOPs, SLA, productivity, and quality standards set by leadership.

Evaluate key performance indicators, provide ongoing reports, and recommend business plan updates.

Perform a wide range of analytics functions in a fast-paced team environment using tools such as Excel, Power BI, and other business intelligence tools.

Analyze payer and product prior authorization, denial, and reimbursement trends.

Design and execute improvement projects.

Conduct complex data analysis and data interpretation.

Meet established deadlines timely, accurately, and with a sense of urgency.

Supervise team including monitoring production and quality to specified goals.

Assist with feedback for hiring, discipline, and performance evaluations.

Oversee the process of providing coverage in a production environment.

Provide department orientation for all direct reports and coordinate training per job description.

Ensure that ongoing training is provided for established employees, including the development & maintenance of standard operating procedures.

Liaison with internal departments to promote ongoing communication and ensure accuracy.

Act as an escalated level of response for concerns and complaints.

Assist staff with enforcing policy.

Work with cross-functional teams to manage the entire process from insurance verification to final collection of prior authorization.

Monitor and validate adherence to policies and procedures, auditing as necessary.

Complete projects and reports in a timely fashion on a daily, weekly, or monthly basis per the direction of management.

Develop, monitor, coach, and manage staff, ensuring the development of employees through orientation, training, establishing objectives, communication of rules, and constructive discipline.

Promote a positive working environment through role modeling, team development, respect, and being fair and consistent.

Qualification

Find out how your skills align with this job's requirements. If anything seems off, you can easily click on the tags to select or unselect skills to reflect your actual expertise.

Billing office managementBilingual spanishPrior authorization submissionRevenue cycle management softwareHealthcare reimbursement knowledgeInsurance billing practicesComputer skillsMicrosoft officePayer eligibility knowledgeHealthcare researchEmployee issue resolutionCommunicationInterpersonalOrganizationalAttention to detailConflict resolutionGoogle Enterprise Suite

Required

Bachelor’s degree or equivalent experience.

Minimum of 3 years of experience in managing a high volume, fast-growing billing office within the laboratory setting is preferred.

Bi-lingual (fluent in Spanish).

Previous experience

Minimum 5 years of experience with prior authorization submission and revenue cycle management software.

Thorough knowledge of healthcare reimbursement (government and private payers) including coverage, coding and payment and understanding of insurance billing practices.

Must be able to communicate effectively both orally and in writing. Strong interpersonal skills.

Strong organizational skills; attention to detail.

Ability to proficiently use a computer and standard office equipment.

Working knowledge of Microsoft Office.

Knowledge of payer eligibility and benefits. Health care research and analysis skills sufficient to support payer research healthcare policy library and state management.

Conflict resolution skills. Must be able to resolve employee issues effectively and efficiently.

Preferred

Minimum of 3 years of experience in managing a high volume, fast-growing billing office within the laboratory setting.

Previous experience with Google Enterprise Suite – Gmail, Slides, Sheets, Docs, Drive.

Benefits

Comprehensive medical, dental, vision, life, and disability plans

Free testing for employees and their immediate families

Fertility care benefits

Pregnancy and baby bonding leave

401k benefits

Commuter benefits

Employee referral program

Company

Natera

Glassdoor

3.5

Natera specializes in cell-free DNA testing to provide a more targeted interventions to oncology, women's health, and organ health.

Founded in 2004

San Carlos, California, USA

1,001-5,000 employees

https://www.natera.com/

H1B Sponsorship

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