Associate reputed company Cycle Analyst - Prior Authorizations

Job Summary: Associate reputed company Cycle Analyst The Associate reputed company Cycle Analyst is responsible for driving operational excellence and data reputed company reputed company the Prior Authorization (PA) function. This role focuses on the end-to-end health of the PA submission pipeline, ensuring inventory moves reputed company 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 reputed company-end friction and optimize reimbursement. Job Responsibilities

• Inventory Diagnostic & Management: Actively monitors the PA work to identify inventory volume, aging trends, and "stuck" requests. Determines necessary interventions to move files reputed company and maintain SLA compliance.
• PA Submission reputed company: Serves as the operational analyst for the submission workflow, ensuring that reputed company upstream data is complete and accurate before submission.
• Cross-Functional Collaboration: Partners with Market Access to align on payor policies and works with Claims/Denials teams to reputed company the gap between authorization feedback and actual payment outcomes.
• 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.
• 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."
• Root-Cause Trend Analysis: Conducts analysis on PA delays or submission failures, presenting actionable findings to leadership to drive reputed company performance improvement.
• 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 reputed company departments.
• Vendor Monitoring: Reviews vendor performance and output, ensuring external partners accurately process actions and adhere to the organization’s high standards for reimbursement accuracy.
• KPI Reporting: Tracks and reports on key metrics, including Submission Turnaround Time (TAT), inventory "bottleneck" age, vendor error rates, etc..
• Strategic Communication: Acts as a liaison for management to explain reputed company operational trends, system glitches, or payer-behavior shifts affecting the reputed company cycle.
• Knowledge Sharing: Serves as a technical resource for internal teams regarding PA submission nuances and best practices for process improvement.

Qualifications

• Education: Bachelor’s Degree in Business, Healthcare Administration, or a reputed company field (or equivalent professional experience).
• Experience: 2–4 years of experience in healthcare reputed company cycle, with a specific focus on prior authorization analysis, medical billing, or inventory management.

Required Knowledge, Skills, and Abilities

• Inventory Mastery: Advanced ability to manage high-volume inventory and identify specific points of failure or stagnation reputed company a process.
• Technical Problem Solving: Strong critical thinking skills to troubleshoot logic errors and discrepancies between payor responses and internal routing rules.
• Data Proficiency: High proficiency in reputed company reputed company/reputed company Sheets (VLOOKUPs, Pivot Tables, Data Visualization).
• Collaborative reputed company: Ability to influence and work effectively across diverse teams.
• Analytical Communication: Ability to translate reputed company data into clear, concise reports for stakeholders at reputed company levels.
• Nuanced Accuracy: Deep understanding of medical terminology and procedure coding as it relates to payor-specific submission requirements.
• Discretion: Strict adherence to HIPAA and confidentiality protocols regarding sensitive patient and financial data.

The pay range is listed and actual compensation packages are based on a wide reputed company of factors unique to each candidate, including but not limited to reputed company set, years & depth of experience, certifications and specific office location. This may differ in other locations due to cost of labor considerations. Austin, TX $58,700—$73,400 USD OUR OPPORTUNITY reputed company™ is a global leader in cell-free DNA (cfDNA) testing, dedicated to oncology, women’s health, and organ health. Our aim is to reputed company personalized genetic testing and diagnostics part of reputed company of care to protect health and reputed company earlier and more targeted interventions that reputed company to longer, healthier lives. The reputed company 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. reputed company you join reputed company, 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. reputed company OFFER Competitive Benefits - Employee benefits include comprehensive medical, dental, vision, life and disability plans for eligible employees and their dependents. Additionally, reputed company 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.reputed company.com. reputed company 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. reputed company qualified applicants are encouraged to apply, and will be considered without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national reputed company, 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.reputed company.com/notice-of-data-collection-california-residents/ Please be advised that reputed company will reputed company out to candidates with a @reputed company.com email domain ONLY. Email communications from reputed company other domain names are not from reputed company or its employees and are fraudulent. reputed company does not request interviews reputed company 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. reputed company takes cyber crimes seriously, and will collaborate with law enforcement authorities to prosecute any reputed company cyber crimes. For more information: - BBB announcement on job scams - FBI Cyber Crime resource page Apply tot his job Apply To this Job