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Associate Revenue Cycle Analyst - Prior Authorizations

<h2>Job Summary: Associate Revenue Cycle Analyst</h2> The Associate Revenue Cycle Analyst is responsible for driving operational excellence and data integrity within the Prior Authorization (PA) function. This role focuses on the end-to-end health of the PA submission pipeline, ensuring inventory moves efficiently to meet established Service Level Agreements (SLAs). By collaborating with internal stakeholders – including Market Access, Genetic Counselors, Medical Records, Insurance Verification, Claims/Denials/Appeals, etc. – this analyst identifies bottlenecks, investigates systemic anomalies, and provides data-driven insights to minimize front-end friction and optimize reimbursement. <h2>Job Responsibilities</h2> <ul> <li style="color: #000000 !important;"> Inventory Diagnostic & Management: Actively monitors the PA work to identify inventory volume, aging trends, and "stuck" requests. Determines necessary interventions to move files forward and maintain SLA compliance. </li> <li style="color: #000000 !important;"> PA Submission Integrity: Serves as the operational analyst for the submission workflow, ensuring that all upstream data is complete and accurate before submission. </li> <li style="color: #000000 !important;"> Cross-Functional Collaboration: Partners with Market Access to align on payor policies and works with Claims/Denials teams to bridge the gap between authorization feedback and actual payment outcomes. </li> <li style="color: #000000 !important;"> Anomaly Investigation: Performs deep-dive investigations into payer and vendor discrepancies (e.g., analyzing why a payer returns "PA Not Required" for a service specifically flagged for authorization) and recommends system logic or workflow adjustments. </li> <li style="color: #000000 !important;"> Requirements & Documentation Management: Identifies and documents specific PA job requirements (e.g., required clinical notes, specific forms, or portal-specific data fields) to ensure submissions are "right the first time." </li> <li style="color: #000000 !important;"> Root-Cause Trend Analysis: Conducts analysis on PA delays or submission failures, presenting actionable findings to leadership to drive continuous performance improvement. </li> <li style="color: #000000 !important;"> Workflow & Tracking Development: Assists in building and refining tracking tools and standardized workflows for the PA lifecycle, specifically focusing on the hand-offs between upstream and downstream departments. </li> <li style="color: #000000 !important;"> Vendor Monitoring: Reviews vendor performance and output, ensuring external partners accurately process actions and adhere to the organization’s high standards for reimbursement accuracy. </li> <li style="color: #000000 !important;"> KPI Reporting: Tracks and reports on key metrics, including Submission Turnaround Time (TAT), inventory "bottleneck" age, vendor error rates, etc.. </li> <li style="color: #000000 !important;"> Strategic Communication: Acts as a liaison for management to explain complex operational trends, system glitches, or payer-behavior shifts affecting the revenue cycle. </li> <li style="color: #000000 !important;"> Knowledge Sharing: Serves as a technical resource for internal teams regarding PA submission nuances and best practices for process improvement. </li> </ul> <h2>Qualifications</h2> <ul> <li style="color: #000000 !important;"> Education: Bachelor’s degree in Business, Healthcare Administration, or a related field (or equivalent years of relevant professional experience). </li> <li style="color: #000000 !important;"> Experience: 2–4 years of experience in healthcare revenue cycle, with a specific focus on prior authorization analysis, medical billing, or inventory management. </li> </ul> <h2>Required Knowledge, Skills, and Abilities</h2> <ul> <li style="color: #000000 !important;"> Inventory Mastery: Advanced ability to manage high-volume inventory and identify specific points of failure or stagnation within a process. </li> <li style="color: #000000 !important;"> Technical Problem Solving: Strong critical thinking skills to troubleshoot logic errors and discrepancies between payor responses and internal routing rules. </li> <li style="color: #000000 !important;"> Data Proficiency: High proficiency in Microsoft Excel/Google Sheets (VLOOKUPs, Pivot Tables, Data Visualization). </li> <li style="color: #000000 !important;"> Collaborative Mindset: Ability to influence and work effectively across diverse teams. </li> <li style="color: #000000 !important;"> Analytical Communication: Ability to translate complex data into clear, concise reports for stakeholders at all levels. </li> <li style="color: #000000 !important;"> Nuanced Accuracy: Deep understanding of medical terminology and procedure coding as it relates to payor-specific submission requirements. </li> <li style="color: #000000 !important;"> Discretion: Strict adherence to HIPAA and confidentiality protocols regarding sensitive patient and financial data. </li> </ul> <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">$58,700—$73,400 USD</div></div></div><div class="content-conclusion">OUR OPPORTUNITY Natera™ 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 OFFER Competitive 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>

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