Prior Authorization Specialist

Inspire Medical Systems, Inc.; Minneapolis (MN); Remote; USD 56,000 - 70,000; Full time

Job summary

A leading medical device firm is looking for a Prior Authorization Specialist to manage insurance verifications and patient intake. This fully remote position requires 3+ years of experience in prior authorization and excellent communication skills. The ideal candidate will support clinics dynamically and ensure timely processing of requests. The firm offers a salary range of $56,000 - $70,000 and flexible time off among other benefits.

Benefits

401k matching

Flexible time off

Tuition reimbursement

Health insurance options

Qualifications

• 3+ years of related work experience in prior authorization.
• Ability to read, interpret and respond to payer requirements.
• High attention to detail and strong team attitude.

Responsibilities

• Support Inspire's Prior Authorization Program.
• Provide flexible coverage across territories.
• Assist in tracking and monitoring progress of prior authorization requests.

Skills

Prior authorization expertise

Attention to detail

Excellent communication

Microsoft Office proficiency

Education

Bachelor's degree

Job description

ABOUT INSPIRE MEDICAL SYSTEMS

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 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!

Fully Remote Position

ABOUT THIS POSITION

We are recruiting for a Prior Authorization Specialist to join our team. In this role, you will provide expertise in the area of prior authorization and play a critical role in ensuring adequate coverage and resource distribution across the department. Unlike the traditional Prior Authorization Specialist role, this position does not have an assigned territory of clinics. Instead, the Float will provide flexible support to clinics and territories as coverage needs arise.

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.
• Provide flexible coverage across territories including:
  • Supporting any assigned clinic/territory as coverage needs dictate
  • Assisting with spikes in volume, staff absences, or temporary coverage gaps
  • Ensuring timely processing of all intakes, submission, and follow-ups
• 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 processes 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 prior authorization requests
  • Working directly with the field and clinic to pursue prior authorization success.
• Work in conjunction with manager and staff to execute action plans and objectives to support internal/external clients.

QUALITY SYSTEM RESPONSIBILITIES

• 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:

• 3+ years of related work experience in prior authorization
• Ability to read, interpret and appropriately respond to payer requirements relating to prior authorization
• Ability to read, interpret and summarize clinical literature
• Excellent written and oral communication skills
• Proficient in Microsoft Office applications, including Word, PowerPoint, Excel
• High attention to detail and strong team attitude
• Ability to manage a high workload while maintaining accuracy and efficiency in a fast-paced setting
• Comfortable in a small, dynamic company environment with frequent changes in direction

Preferred:

• Bachelor's degree
• Medical device experience
• Experience working in a clinic or medical practice environment

The salary for this position will be offered at a level consistent with the experience and qualifications of the candidate. The salary range is $56,000 - $70,000 USD.

BENEFITS AND OTHER COMPENSATION

• 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.

Inspire Medical Systems is an equal 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 [e-mail]

Inspire Medical Systems participates in E-Verify.