Prior Authorization Specialist

Inspiresleep; Golden Valley (MN); On-site; USD 56,000 - 84,000; Full time

Job summary

Join a leading company in sleep innovation as a Prior Authorization Specialist. You'll implement and manage a critical authorization program, ensuring effective communication with healthcare providers and insurance agencies to enhance patient access to life-changing medical devices.

Benefits

Flexible time off

Tuition reimbursement

401k matching

Employee Stock Purchase Program

Health savings account contributions

Qualifications

• 2+ years of related work experience in reimbursement.
• Ability to read and interpret payer requirements for prior authorization.

Responsibilities

• Manage patient information and verify insurance coverage.
• Track and monitor prior authorization requests and appeals.

Skills

Reimbursement compliance

Written communication

Oral communication

Attention to detail

Team collaboration

Proficient in Microsoft Office

Job description

Inspire is the first of its kind medical device designed to make a difference in the lives of those living with Obstructive Sleep Apnea (OSA). We are revolutionizing the sleep industry with our FDA-approved medical device, designed to reduce OSA severity for those who cannot tolerate or get consistent benefit from CPAP. Inspire Medical Systems is committed to enhancing patients’ lives through sleep innovation. We are steadfast in our commitment to prioritize patient outcomes, act with integrity and lead with respect. With positive persistence at our core, we are committed to all those we serve.

WHY JOIN OUR FAST-GROWING TEAM

At Inspire, we value people – your diverse experiences, backgrounds, and thoughts. We elevate voices and encourage learning opportunities to build a professional network that grows into community. We embrace a people-first culture by offering hybrid work schedules, excellent benefits, 401k matching, ESPP, flexible time off (FTO), and tuition reimbursement.

If you’re passionate about making a difference in people’s lives and want to work with innovative technology, come be a part of our great team!

ABOUT THIS POSITION

We are recruiting for a Prior Authorization Specialist to join our team. In this role, you will be providing expertise in the area of prior authorization and will be responsible for implementing the Inspire Prior Authorization Program in the United States. You will be working with the Territory Managers and the prior authorization team to ensure all coding and coverage questions are answered correctly and concisely.

OPPORTUNITIES YOU WILL HAVE IN THIS ROLE

• Support Inspire’s Prior Authorization Program, including:
  • Entering and managing patient information in database
  • Assisting with patient intake and verifying of insurance coverage
  • Calling insurances to obtain the status of Prior authorization requests
  • Working with patients and sites to pursue authorization success.
• Assist in tracking and monitoring progress of prior authorization requests, along with all related appeals through to EMR.
• Participate in updating the packet of materials and best practices methods to support the prior authorization and appeals processes, including External Medical Review, (EMR) for upper airway stimulation.
• Seek continuous process improvement to increase success rates and reduce time to success.
• Implement Inspire’s Prior Authorization Program, including:
  • Training sites on program requirements
  • Entering and managing patient information in database
  • Completing prior authorization requests
  • Providing guidance to participating sites on all levels of appeals including EMR
  • Working directly with the patient to pursue EMR success.
• Provide general coding information to physician customers upon request.
• Work in conjunction with manager and staff to execute action plans and objectives to support internal/external clients.

QUALITY SYSTEM RESPONSIBILITIES

• Document product and therapy related field reports within the prescribed timelines and provide any necessary documents required to complete the investigation. Provide follow-up reporting as needed.
• Complete training requirements and competency confirmations as required for this position within the required timeline.
• Comply with applicable quality system procedures/policies and make suggestions for continuous process improvement.

WHAT YOU CAN BRING TO OUR GREAT TEAM

Required:

• 2+ years of related work experience in reimbursement
• Demonstrated knowledge of reimbursement compliance requirements and a maintaining a 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

Preferred:

The salary for this position will be offered at a level consistent with the experience and qualifications of the candidate. This information reflects the anticipated salary range for this position at the time of posting. The salary range may be modified in the future and actual compensation may vary from the posting based on various factors such as geographic location, work experience, education and/or skill level.

$56,000 - $84,000 USD

BENEFITS AND OTHER COMPENSATION

Inspire offers a highly competitive benefits package including (general description of the benefits and other compensation offered):

• Multiple health insurance plan options.
• Employer contributions to Health Savings Account.
• Dental, Vision, Life and Disability benefits.
• 401k plan + employer match.
• Identity Protection.
• Flexible time off.
• Tuition Reimbursement.
• Employee Assistance program.
• All employees have the opportunity to participate in the ownership and success of Inspire. Employees at all levels can participate through equity awards and the Employee Stock Purchase Program.

Inspire Medical Systems provides equal employment opportunity (EEO) to all employees and applicants without regard to race, color, religion, creed, sex, national origin, age, disability, marital status, familial status, sexual orientation, status regarding public assistance, membership or activity in a local commission, military or veteran status, genetic information, pregnancy or childbirth, or any other status protected by applicable federal, state, and local laws. This policy applies to all aspects of the employment relationship, including recruitment, hiring, compensation, promotion, transfer, disciplinary action, layoff, return from layoff, training, and social and recreational programs. Inspire Medical Systems complies with applicable laws governing non-discrimination in employment in every location in which Inspire Medical Systems has facilities. All such employment decisions will be made without unlawfully discriminating on any prohibited basis.

Inspire Medical Systems is anequal opportunity employer with recruitment efforts focused on ensuring a diverse workforce.Applicants with a disability that need accommodation to complete the Inspire Medical Systems application process should contact Human Resources at 844-672-4357 or email careers@inspiresleep(dot)com

Inspire Medical Systems participates in E-Verify.

Create a Job Alert

Interested in building your career at Inspire Medical Systems Inc.? Get future opportunities sent straight to your email.

Apply for this job

*

indicates a required field

First Name *

Last Name *

Preferred First Name

Email *

Phone

Resume/CV

Enter manually

Accepted file types: pdf, doc, docx, txt, rtf

Enter manually

Accepted file types: pdf, doc, docx, txt, rtf

LinkedIn Profile

Website

Are you currently bound by a non-compete agreement that would prohibit you from fulfilling your job duties or working at Inspire Medical Systems? * Select...

Are you legally authorized to work in the Country you are applying? * Select...

Will you now or in the future require immigration sponsorship for employment visa status? * Select...

Are you open to relocation? * Select...

Are you willing to submit to a pre-employment background check and drug screen? * Select...

Have you ever been employed by Inspire Medical Systems before? * Select...

How did you learn about this opportunity? * Select...

What is your highest level of education? * Select...

What is your desired salary?

Do you want to tell us anything else about yourself?

Self Attestation is required. *

Yes, I agree to sign electronically

I certify that I have read and understand the applicant instructions included with this application and that the answers given by me to the foregoing questions and statements made by me are complete and true to the best of my knowledge and belief.

I understand that any false information, omissions or misrepresentations of facts called for in this application, whether on this document or not, may result in rejection of my application or discharge at any time during my employment.

I understand that this application form is intended for use in evaluating my qualifications for employment and that this application is not an offer of employment. I further understand that if hired, my employment will be considered "at-will" and that my employment may be terminated for any reason, with or without cause or notice, at any time by me or the Company and that this application is not intended to constitute a contract of continued employment.

Voluntary Self-Identification

For government reporting purposes, we ask candidates to respond to the below self-identification survey.Completion of the form is entirely voluntary. Whatever your decision, it will not be considered in the hiringprocess or thereafter. Any information that you do provide will be recorded and maintained in aconfidential file.

As set forth in Inspire Medical Systems Inc.’s Equal Employment Opportunity policy,we do not discriminate on the basis of any protected group status under any applicable law.

If you believe you belong to any of the categories of protected veterans listed below, please indicate by making the appropriate selection.As a government contractor subject to the Vietnam Era Veterans Readjustment Assistance Act (VEVRAA), we request this information in order to measurethe effectiveness of the outreach and positive recruitment efforts we undertake pursuant to VEVRAA. Classification of protected categoriesis as follows:

A "disabled veteran" is one of the following: a veteran of the U.S. military, ground, naval or air service who is entitled to compensation (or who but for the receipt of military retired pay would be entitled to compensation) under laws administered by the Secretary of Veterans Affairs; or a person who was discharged or released from active duty because of a service-connected disability.

A "recently separated veteran" means any veteran during the three-year period beginning on the date of such veteran's discharge or release from active duty in the U.S. military, ground, naval, or air service.

An "active duty wartime or campaign badge veteran" means a veteran who served on active duty in the U.S. military, ground, naval or air service during a war, or in a campaign or expedition for which a campaign badge has been authorized under the laws administered by the Department of Defense.

An "Armed forces service medal veteran" means a veteran who, while serving on active duty in the U.S. military, ground, naval or air service, participated in a United States military operation for which an Armed Forces service medal was awarded pursuant to Executive Order 12985.

Select...

Voluntary Self-Identification of Disability

Form CC-305

Page 1 of 1

OMB Control Number 1250-0005

Expires 04/30/2026

Voluntary Self-Identification of Disability

Form CC-305 Page 1 of 1 OMB Control Number 1250-0005 Expires 04/30/2026
Why are you being asked to complete this form?

We are a federal contractor or subcontractor. The law requires us to provide equal employment opportunity to qualified people with disabilities. We have a goal of having at least 7% of our workers as people with disabilities. The law says we must measure our progress towards this goal. To do this, we must ask applicants and employees if they have a disability or have ever had one. People can become disabled, so we need to ask this question at least every five years.

Completing this form is voluntary, and we hope that you will choose to do so. Your answer is confidential. No one who makes hiring decisions will see it. Your decision to complete the form and your answer will not harm you in any way. If you want to learn more about the law or this form, visit the U.S. Department of Labor’s Office of Federal Contract Compliance Programs (OFCCP) website at www.dol.gov/ofccp .

How do you know if you have a disability?

A disability is a condition that substantially limits one or more of your “major life activities.” If you have or have ever had such a condition, you are a person with a disability. Disabilities include, but are not limited to:

• Alcohol or other substance use disorder (not currently using drugs illegally)
• Autoimmune disorder, for example, lupus, fibromyalgia, rheumatoid arthritis, HIV/AIDS
• Blind or low vision
• Cancer (past or present)
• Cardiovascular or heart disease
• Celiac disease
• Cerebral palsy
• Deaf or serious difficulty hearing
• Diabetes
• Disfigurement, for example, disfigurement caused by burns, wounds, accidents, or congenital disorders
• Epilepsy or other seizure disorder
• Gastrointestinal disorders, for example, Crohn's Disease, irritable bowel syndrome
• Intellectual or developmental disability
• Mental health conditions, for example, depression, bipolar disorder, anxiety disorder, schizophrenia, PTSD
• Missing limbs or partially missing limbs
• Mobility impairment, benefiting from the use of a wheelchair, scooter, walker, leg brace(s) and/or other supports
• Nervous system condition, for example, migraine headaches, Parkinson’s disease, multiple sclerosis (MS)
• Neurodivergence, for example, attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder, dyslexia, dyspraxia, other learning disabilities
• Partial or complete paralysis (any cause)
• Pulmonary or respiratory conditions, for example, tuberculosis, asthma, emphysema
• Short stature (dwarfism)
• Traumatic brain injury

Disability Status * Select...

PUBLIC BURDEN STATEMENT: According to the Paperwork Reduction Act of 1995 no persons are required to respond to a collection of information unless such collection displays a valid OMB control number. This survey should take about 5 minutes to complete.