Prior Authorization Knowledge & Policy Specialist

<h3>ABOUT NATERA:</h3>Natera is a global leader in cell-free DNA (cfDNA) testing, dedicated to helping families and healthcare providers make more informed decisions. Through cutting-edge technology and a commitment to innovation, Natera offers genetic testing solutions that span reproductive health, oncology, and organ health. We are passionate about delivering accurate, actionable insights that improve patient outcomes and transform the way diseases are detected and managed.<h3>POSITION SUMMARY:</h3>The Authorization Resource Center (RC) is the central hub for all knowledge, processes, and payer policies related to prior authorizations (PAs) across our organization. As a Prior Authorization Knowledge & Policy Specialist, you will gather PA requirements directly from insurance plans, translate them into clear resources and job aids, and support internal teams with accurate, up-to-date guidance. You’ll triage information requests via Jira, partner closely with Market Access and Insurance Billing, and help build a best-in-class knowledge base in a fast-moving, rapidly evolving environment.KEY RESPONSIBILITIES:Focus Area: Payer Policy Research & Advocacy<ul><li>Contact payers to confirm PA requirements, covered codes, and portal workflows.</li><li>Document findings in standard templates; update configurations in billing/eligibility systems.</li><li>Serve as a subject-matter expert on test-specific authorization criteria and payer nuances.</li></ul>Resource & Job-Aid Development <ul><li>Create step-by-step guides (job aids) for submitting and obtaining PAs through Availity and other payer portals.</li><li>Maintain a searchable knowledge library covering “which tests require authorization” and “how to configure system flags.”</li></ul>Ticket Management (Jira)<ul><li>Monitor and respond to information-request tickets from clinical, billing, and customer-service teams.</li><li>Prioritize, resolve, and close tickets, ensuring accurate documentation and timely SLAs.</li></ul>Process Improvement & Education<ul><li>Identify recurring pain points; propose workflow changes to reduce denials and turnaround time.</li><li>Train cross-functional stakeholders on new PA policies, resources, and best practices.</li><li>Contribute to ARC team stand-ups and retrospectives, sharing insights and lessons learned.</li></ul>Change Readiness & Agility<ul><li>Thrive in a “build-as-we-go” setting—adapt quickly as payer rules, internal processes, and team structures evolve.</li><li>Proactively surface gaps in knowledge content and help define new processes as the ARC matures.</li></ul> <h3>REQUIRED QUALIFICATIONS:</h3><ul><li>Prior Authorization Expertise – 2 + years in PA advocacy, revenue-cycle, or insurance verification (hospital, laboratory, or health-tech setting). </li><li>Payer-Facing Communication – Comfortable calling payer reps to clarify requirements and escalating when necessary. </li><li>Documentation Strength – Proven ability to write concise, step-by-step instructions and policy summaries. </li><li>Process-Improvement Mindset – Experience mapping workflows, spotting inefficiencies, and driving corrective action. </li><li>Technical Tools – Familiarity with Jira (or similar ticketing), MS Office (advanced Excel a plus for code/policy tracking), and common payer portals (e.g., Availity). </li><li>Adaptability & Self-Direction – Demonstrated success in unstructured, fast-changing environments; self-starter who needs minimal oversight. </li><li>Education – Bachelor’s degree or equivalent combination of training and hands-on PA/RCM experience. </li></ul><h3>PREFERRED KNOWLEDGE & ABILITIES:</h3><ul><li>Prior experience building knowledge bases, SOPs, or job-aid libraries from the ground up. </li><li>Exposure to automation/AI solutions in revenue-cycle or health-tech workflows. </li><li>Understanding of CPT/HCPCS coding and its impact on authorization requirements. </li><li>Strong presentation skills for educating diverse internal audiences.</li></ul> <h3>Why Join Us?</h3>You’ll have a front-row seat in shaping a brand-new function that directly impacts patient access and revenue integrity. If you love turning complex policies into crystal-clear guidance—and you thrive on change—ARC is where you can make a lasting mark.  #LI-AB1<div class="content-pay-transparency"><div class="pay-input"><div class="description">The pay range is listed and actual compensation packages are based on a wide array of factors unique to each candidate, including but not limited to skill set, years & depth of experience, certifications and specific office location. This may differ in other locations due to cost of labor considerations.</div><div class="title">Austin, TX</div><div class="pay-range">$59,900—$84,900 USD</div></div></div><div class="content-conclusion">OUR OPPORTUNITYNatera™ is a global leader in cell-free DNA (cfDNA) testing, dedicated to oncology, women’s health, and organ health. Our aim is to make personalized genetic testing and diagnostics part of the standard of care to protect health and enable earlier and more targeted interventions that lead to longer, healthier lives.The Natera team consists of highly dedicated statisticians, geneticists, doctors, laboratory scientists, business professionals, software engineers and many other professionals from world-class institutions, who care deeply for our work and each other. When you join Natera, you’ll work hard and grow quickly. Working alongside the elite of the industry, you’ll be stretched and challenged, and take pride in being part of a company that is changing the landscape of genetic disease management.WHAT WE OFFERCompetitive Benefits - Employee benefits include comprehensive medical, dental, vision, life and disability plans for eligible employees and their dependents. Additionally, Natera employees and their immediate families receive free testing in addition to fertility care benefits. Other benefits include pregnancy and baby bonding leave, 401k benefits, commuter benefits and much more. We also offer a generous employee referral program!For more information, visit <a href="http://www.natera.com/" data-cke-saved-href="http://www.natera.com/">www.natera.com</a>.Natera is proud to be an Equal Opportunity Employer. We are committed to ensuring a diverse and inclusive workplace environment, and welcome people of different backgrounds, experiences, abilities and perspectives. Inclusive collaboration benefits our employees, our community and our patients, and is critical to our mission of changing the management of disease worldwide.All qualified applicants are encouraged to apply, and will be considered without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, age, veteran status, disability or any other legally protected status. We also consider qualified applicants regardless of criminal histories, consistent with applicable laws.If you are based in California, we encourage you to read this important information for California residents. Link: <a href="https://www.natera.com/notice-of-data-collection-california-residents" target="_blank">https://www.natera.com/notice-of-data-collection-california-residents/</a>Please be advised that Natera will reach out to candidates with a @<a href="http://natera.com/" target="_blank" data-saferedirecturl="https://www.google.com/url?q=http://natera.com&source=gmail&ust=1657718972773000&usg=AOvVaw3zRwaIiu7070kJKNG4hjRm">natera.com</a> email domain ONLY. Email communications from all other domain names are not from Natera or its employees and are fraudulent. Natera does not request interviews via text messages and does not ask for personal information until a candidate has engaged with the company and has spoken to a recruiter and the hiring team. Natera takes cyber crimes seriously, and will collaborate with law enforcement authorities to prosecute any related cyber crimes.For more information: - <a href="https://www.bbb.org/article/tips/12261-bbb-tip-employment-scams" target="_blank">BBB announcement on job scams</a>  - <a href="https://www.fbi.gov/investigate/cyber" target="_blank">FBI Cyber Crime resource page</a> </div>

Prior Authorization Knowledge & Policy Specialist

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