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Vendor Management, Prior Authorization

Natera

Natera

Remote
Posted on Saturday, May 25, 2024

Job Summary:

The Vendor Management, Revenue Cycle is responsible for developing and maintaining successful relationships with our vendor network, establishing and measuring required performance levels from vendor onboarding throughout the entire relationship, and assuming primary responsibility for maintaining open and effective lines of communication between both parties.

Job Responsibilities:

  • Effectively and simultaneously manages multiple large vendors utilized for processes related to the submission of prior authorization requests.
  • Ensures timely/accurate submission and associated subsequent work of all prior authorizations assigned to each vendor.
  • Analyze/manage vendor performance based on established metrics.
  • Monitor and direct work to obtain prior authorization outcomes, including analyzing reimbursement, prior authorization decisions, and denials management.
  • Participate in regularly scheduled meetings with managers/supervisors to assess issues and to identify/implement improvements for more efficient operations.
  • Develop actionable roadmaps for improving workflows and processes.
  • Meets established deadlines timely, accurately, and with a sense of urgency.
  • Represent organizational projects and assist management with follow-through and implementation of initiatives.
  • Assists with implementing strategic goals through utilization of vendors and their staff.
  • Act as a liaison with internal departments to promote ongoing communication, and collaboration on cross-functional projects related to prior authorization.
  • Monitor and validate adherence to Policies and Procedures, auditing as necessary.
  • Foster positive working relationships and regular communications between vendors and client.
  • Maintain a current status on Natera training requirements.
  • Performs other duties as assigned.
  • Completion of all training related 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.
  • This role works with PHI on a regular basis both in paper and electronic form and have an access to various technologies to access PHI (paper and electronic) in order to perform the job.

QUALIFICATIONS:

  • Minimum of 5 years of revenue cycle experience in a high volume, fast growing billing company/office (direct experience with the prior authorization process and in a laboratory setting is preferred).
  • Extensive knowledge of reimbursement, billing, coding and compliance regulations is required.

KNOWLEDGE, SKILLS, AND ABILITIES:

  • Training in positions within the healthcare revenue cycle. Normally requires a minimum of two (2) years directly related and progressively responsible experience.
  • Ability to perform complex analysis and discuss with upper management.
  • Skilled in Microsoft Office: Word and Excel.
  • Ability to communicate effectively both orally and in writing. Strong interpersonal skills.
  • Strong organizational skills, including attention to detail.
  • Knowledge of payer guidelines and prior authorization guidelines/requirements.
  • Health care research and analysis skills sufficient to support payer research healthcare policy library and state management.
  • Ability to resolve associate issues effectively and efficiently.
  • Advanced proficiency with quantitative software programs (Microsoft Excel, Google Sheets).
  • Experience with BI tools preferred.
  • Ability to define problems, collect and reconcile data, and validate data against source information.
  • Motivated, shows initiative and ability to work in fast paced environment.
  • Drive for results (Service, Quality, and Continuous Improvement).
  • Commitment to successful achievement of team and organizational goals.
  • Demonstrate a focus on listening to and understanding client/vendor needs.

PHYSICAL DEMANDS & WORK ENVIRONMENT:

Duties are typically performed in an office setting. This position requires the ability to use a computer keyboard, communicate over the telephone and read printed material. Duties may require working outside normal working hours (evenings and weekends) at times.

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.


San Carlos, CA
$105,400—$131,800 USD


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 www.natera.com.

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: https://www.natera.com/notice-of-data-collection-california-residents/

Please be advised that Natera will reach out to candidates with a @natera.com 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:
- BBB announcement on job scams
- FBI Cyber Crime resource page

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.
Remote USA
$105,400$131,800 USD

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 www.natera.com.

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: https://www.natera.com/notice-of-data-collection-california-residents/

Please be advised that Natera will reach out to candidates with a @natera.com 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:
- BBB announcement on job scams
- FBI Cyber Crime resource page