Billing Strategy Lead, Prior Authorizations

About Natera: 

​Natera is a global leader in cell-free DNA (cfDNA) testing, specializing in oncology, women's health, and organ health. Our mission is to integrate personalized genetic testing and diagnostics into standard healthcare practices, facilitating earlier and more targeted interventions that contribute to longer, healthier lives.

Leveraging a cutting-edge technology platform that combines novel molecular biology techniques with advanced bioinformatics software, Natera can detect down to a single molecule in a blood sample. This technology underpins a range of products, including Panorama™, a highly accurate noninvasive prenatal test; Signatera™, a tumor-specific assay for individualized cancer care; and Prospera™, a test for assessing rejection in kidney transplantation. ​

Founded in 2004 and headquartered in Austin, Texas, Natera operates CAP-accredited laboratories certified under the Clinical Laboratory Improvement Amendments (CLIA) in both San Carlos, California, and Austin, Texas. We have processed over 10 million tests and have more than 150 medical professionals on staff, providing expert support to help make test results clear and easy to understand.

POSITION SUMMARY: The Billing Strategy Lead, Prior Authorizations is responsible for monitoring and analyzing operational data metrics and working collaboratively with the prior authorization teams to ensure optimal operational performance. The ideal candidate will have strong data analysis skills, experience with prior authorization operations, and expertise in PowerBI. 

PRIMARY RESPONSIBILITIES:

• Participate in regularly scheduled meetings with managers/supervisors to assess issues and to identify and implement improvements for more-efficient operations
• Provide strong, timely financial and business analytics for decisions by organizational stakeholders
• Develop actionable roadmaps for improving workflows and processes
• Performs in-depth reviews/audits to identify issues/trends and create remediation
• plan(s)
• Coordinate with multiple teams within the organization for process
• improvement/efficiencies
• Support management of projects to ensure successful and timely completion
• Support management in monitoring and tracking adherence of SOPs, SLAs, productivity and quality standards set by leadership
• Evaluate key performance indicators, provide ongoing reports, and recommend business plan updates
• Support the Billing Strategy team in management of projects and preparation of adhoc/weekly reports and presentations
• Performs a wide range of analytics functions in a fast-paced team environment using tools such as Excel, Power BI and other business intelligence tools
• Analyzes payer and product prior authorization, denial, and reimbursement
• trends
• Designs and executes improvement projects
• Conducts complex data analysis and data interpretation  
• Meets established deadlines timely, accurately, and with a sense of urgency 
• Performs other duties as assigned
• This role works with PHI on a regular basis both in paper and electronic form and will have access to various technologies to access PHI (paper and electronic) in order to perform the job
• Employee must complete training relating to HIPAA/PHI privacy, General Policies and Procedure Compliance training and security training as soon as possible but not later than the first 30 days of hire
• Must maintain a current status on Natera training requirements

QUALIFICATIONS:

• Bachelor’s Degree in business, economics, related field, or equivalent required.
• Minimum of 4 years of experience working with prior authorizations at an insurance company or healthcare billing organization.

KNOWLEDGE, SKILLS, AND ABILITIES:

• Advanced proficiency with quantitative software programs (Microsoft Excel, Google Sheets).
• Ability to define problems, collect and reconcile data, validate data against source information.
• Motivated, shows initiative, and ability to work in a fast paced environment.
• Drive for Results (Service, Quality, and Continuous Improvement).
• Commitment to the successful achievement of team and organizational goals.

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