Reimbursement Coordinator II

Medtronic; United States; Remote; USD 55,000 - 75,000; Full time

Job summary

Medtronic plc, a global leader in healthcare technology, seeks a Remote Prior Authorization Representative in the United States to support Neuromodulation reimbursement pathways. The role coordinates prior authorization activities with provider offices, payers, and field teams to verify coverage, submit documentation, monitor progress, and resolve issues, ensuring timely patient access to therapies.

Experience in Medicare/Medicaid, strong Excel and CRM skills, and the ability to manage multiple

Qualifications

• High School Diploma and 2+ years in prior authorization, reimbursement, healthcare revenue cycle, payer operations, insurance verification, or patient access support.
• Experience with Medicare, Medicaid, and commercial payer authorization processes.
• Experience reviewing and coordinating medical documentation for prior authorization submissions.
• Experience using Microsoft Excel and case management, customer relationship management (CRM), or healthcare workflow systems.
• Experience managing multiple cases simultaneously while meeting quality and turnaround requirements.

Responsibilities

• Verify patient insurance benefits, coverage eligibility, and prior authorization requirements.
• Initiate, submit, and track prior authorization requests with Medicare, Medicaid, and commercial payers.
• Coordinate collection and review of clinical documentation, medical records, coding information, and required forms to support authorization submissions.
• Monitor authorization status and proactively follow up with provider offices and payers to support timely coverage decisions.
• Analyze authorization denials and support reconsideration, resubmission, and appeal activities when appropriate.
• Interpret payer coverage policies, reimbursement requirements, and authorization criteria to support accurate submissions and case resolution.
• Partner with field personnel and healthcare provider offices to provide guidance on authorization processes, reimbursement pathways, and payer requirements.
• Maintain accurate case records, reporting data, and reimbursement resources while supporting operational audits, productivity monitoring, and process improvements.

Skills

Prior authorization

Healthcare revenue cycle

Payer operations

Insurance verification

CRM systems

Microsoft Excel

Case management

Education

High School Diploma

Diploma

AAPC Coding Certification

Tools

Salesforce

Healthcare workflow systems

Job description

Remote

Careers that change lives start here. Medtronic is a global leader in healthcare technology with a Mission to alleviate pain, restore health, and extend life. Our 95,000 employees work across more than 150 countries to put patients first — developing innovative medical technologies that improve the lives of 72+ million patients each year. Your unique talents will help shape the future of healthcare while building a career grounded in purpose, growth, and impact.

A Day in the Life

The Neuromodulation Operating Unit partners with healthcare providers, patients, and payers to help ensure timely access to Medtronic therapies. The reimbursement and prior authorization function supports patient access by navigating payer requirements, coverage policies, and authorization workflows across Medicare, Medicaid, and commercial health plans.

Check us out on LinkedIn: Medtronic Brain Modulation and Pain Interventions

This is a remote position within the United States with no travel required.

Team members collaborate virtually with provider offices, field-based partners, payer representatives, and internal stakeholders to support prior authorization and reimbursement activities.

This role is responsible for coordinating prior authorization activities to support patient access to Neuromodulation therapies. The Prior Authorization Representative works closely with healthcare provider offices, payers, field teams, and internal partners to verify insurance coverage, facilitate authorization submissions, monitor case progress, resolve reimbursement-related issues, and support coverage approvals.

Primary Responsibilities

• Verify patient insurance benefits, coverage eligibility, and prior authorization requirements.
• Initiate, submit, and track prior authorization requests with Medicare, Medicaid, and commercial payers.
• Coordinate collection and review of clinical documentation, medical records, coding information, and required forms to support authorization submissions.
• Monitor authorization status and proactively follow up with provider offices and payers to support timely coverage decisions.
• Analyze authorization denials and support reconsideration, resubmission, and appeal activities when appropriate.
• Interpret payer coverage policies, reimbursement requirements, and authorization criteria to support accurate submissions and case resolution.
• Partner with field personnel and healthcare provider offices to provide guidance on authorization processes, reimbursement pathways, and payer requirements.
• Maintain accurate case records, reporting data, and reimbursement resources while supporting operational audits, productivity monitoring, and process improvements.

Required Qualifications

• High School Diploma and 2+ years of experience in prior authorization, reimbursement, healthcare revenue cycle, payer operations, insurance verification, or patient access support.
• Experience working with Medicare, Medicaid, and commercial payer authorization processes.
• Experience reviewing and coordinating medical documentation for prior authorization submissions.
• Experience using Microsoft Excel and case management, customer relationship management (CRM), or healthcare workflow systems.
• Experience managing multiple cases simultaneously while meeting quality and turnaround requirements.

Preferred Qualifications

• Diploma
• American Academy of Professional Coders (AAPC) Coding Certification.
• Experience supporting medical device, neuromodulation, or healthcare reimbursement programs.
• Knowledge of ICD-10 and Current Procedural Terminology (CPT) coding.
• Experience using Salesforce and healthcare reimbursement or patient access platforms.
• For Baccalaureate degrees earned outside of the United States, a degree that satisfies the requirements of 8 C.F.R. § 214.2(h)(4)(iii)(A) is required.