Prior Authorization Specialist

🔥 30 minutes ago

❄️ Minnesota – Remote

❄️ Minnesota – Remote

💵 $50k - $70k / year

⏰ Full Time

🟢 Junior

🟡 Mid-level

🚫👨‍🎓 No degree required

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Inspire Medical Systems

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 2007

🏥 Healthcare

🏭 Manufacturing

🔧 Hardware

💰 $133.4M Post-IPO Equity - Inspire Medical Systems on 2020-04

Healthcare • Manufacturing • Hardware

Inspire Medical Systems is a medical technology company that develops and commercializes a proprietary, implantable neurostimulation system (Inspire Therapy) for the treatment of moderate to severe obstructive sleep apnea. The company focuses on minimally invasive solutions backed by FDA approval, clinical data, and payer coverage to reach patients through healthcare providers and payers.

📋 Description

• Provide expertise in prior authorization and implement the Inspire Prior Authorization Program in the United States • Work with Territory Managers and the prior authorization team to answer coding and coverage questions • Enter and manage patient information in databases • Assist with patient intake and verify insurance coverage • Call insurance providers to obtain prior authorization request status • Work with patients and sites to pursue authorization success • Track and monitor prior authorization requests and related appeals through External Medical Review (EMR) • Update materials and best practices supporting prior authorization and appeals processes • Seek continuous process improvement to increase success rates and reduce time to success • Train sites on program requirements • Complete prior authorization requests • Provide guidance to sites on appeals, including EMR • Work directly with patients to pursue EMR success • Provide general coding information to physician customers • Execute action plans and objectives with managers and staff to support internal/external clients • Document product and therapy-related field reports and provide follow-up reporting • Complete required training and competency confirmations • Comply with quality system procedures and policies

🎯 Requirements

• 2+ years of related work experience in reimbursement • Demonstrated knowledge of reimbursement compliance requirements • High level of personal integrity to promote a compliant reimbursement environment • Ability to read, interpret and appropriately respond to payer requirements relating to prior authorization • Ability to read, interpret and summarize clinical and cost literature • Excellent written and oral communication skills • Proficient in Microsoft Office applications, including Word, PowerPoint, Excel • High attention to detail and strong team attitude • Comfortable in a small, dynamic company environment with frequent changes in direction • Bachelor’s degree preferred • Medical device experience preferred

🏖️ Benefits

• Excellent benefits • 401k matching • Employee Stock Purchase Program (ESPP) • Flexible time off (FTO) • Tuition reimbursement • Multiple health insurance plan options • Employer contributions to Health Savings Account • Dental, Vision, Life and Disability benefits • 401k plan + employer match • Identity Protection • Employee Assistance program • Equity awards • Employee Stock Purchase Program

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