Supervisor, Prior Authorizations

Supervisor, Prior Authorization

Job Summary

The Supervisor, Prior Authorization is responsible for overseeing the daily operations and performance of teams supporting the Prior Authorization function within Natera's Billing Operations department. This position provides direct operational oversight of the Prior Authorization Denials & Appeals, PA360, and PA Mismatch teams, including both domestic and offshore employees.

The Supervisor is responsible for ensuring timely and accurate resolution of prior authorization issues, managing team productivity and quality, monitoring payer requirements, and driving operational improvements that support authorization compliance and minimize reimbursement delays. This role partners closely with internal stakeholders and external teams to resolve escalated issues, identify process inefficiencies, and optimize prior authorization workflows.

Key Responsibilities

• Oversee the daily operations of the Prior Authorization Denials & Appeals, PA360, and PA Mismatch teams, ensuring efficient workflow management, timely case resolution, and adherence to departmental performance standards.
• Provide day-to-day leadership, coaching, and performance management for both domestic and offshore team members, ensuring consistency in processes, quality, and productivity across teams.
• Monitor team performance against established KPIs, including productivity, turnaround times, case resolution rates, quality, backlog management, and other operational metrics.
• Oversee the review, investigation, and resolution of prior authorization denials, including coordination of appeals, identification of denial trends, and implementation of corrective actions to reduce recurring issues.
• Ensure timely identification, investigation, and resolution of prior authorization discrepancies, mismatches, and other authorization-related issues that may impact claim processing or reimbursement.
• Monitor work queues, case volumes, and aging inventory to ensure appropriate workload distribution, timely follow-up, and resolution of outstanding authorization cases.
• Serve as an escalation point for complex prior authorization issues, payer disputes, authorization discrepancies, and other operational challenges requiring additional investigation or cross-functional coordination.
• Collaborate with internal teams, including Billing, Insurance Verification, Denials & Appeals, and other Revenue Cycle functions, to resolve authorization-related issues and improve end-to-end billing workflows.
• Partner with offshore team leads and operational stakeholders to ensure alignment on workflows, performance expectations, training, quality standards, and escalation procedures.
• Identify trends and root causes contributing to prior authorization denials, authorization mismatches, processing delays, and other operational inefficiencies; recommend and implement process improvements.
• Ensure team adherence to payer-specific authorization requirements, internal policies and procedures, documentation standards, and applicable healthcare regulations.
• Conduct regular quality reviews and audits to ensure accuracy, completeness, and compliance with established prior authorization processes and payer guidelines.
• Prepare, analyze, and communicate operational performance reports, identifying trends, areas of concern, and opportunities to improve team efficiency and authorization outcomes.
• Support the development, implementation, and maintenance of standardized workflows, training materials, and standard operating procedures (SOPs) across assigned teams.
• Participate in hiring, onboarding, training, employee development, and performance evaluations to build and maintain a high-performing team.
• Foster a collaborative, accountable, and continuous-improvement-focused team environment that supports operational excellence and departmental objectives.

Qualifications

• 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, with demonstrated experience in 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, with the ability to investigate complex issues and develop actionable solutions.

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