Remote Prior Authorization Pro

Inspire Medical Systems; United States; Remote; USD 45,000 - 65,000; Full time

Job summary

Inspire Medical Systems is seeking a remote Prior Authorization Specialist in the United States. You will support the company’s Prior Authorization Program and work with Territory Managers to ensure correct coding and coverage decisions.

You will handle patient intake, verify insurance coverage, and pursue authorization success with insurances, patients, and sites. Responsibilities include managing PA requests and related EMR documentation, updating best practices, and guiding appeals and coding

Qualifications

• 2+ years of reimbursement experience.
• Knowledge of reimbursement compliance requirements.
• Ability to read and summarize payer requirements.
• Strong written and verbal communication.
• Detail-oriented with a collaborative mindset.

Responsibilities

• Enter and manage patient information in the database.
• Assist with patient intake and verify insurance coverage.
• Call insurers to check prior authorization status.
• Coordinate with patients and sites to pursue authorization success.
• Track progress of prior authorization requests and appeals in EMR.
• Update materials and best practices for PA and appeals.
• Provide guidance on appeals including EMR.
• Collaborate with manager and staff on action plans.

Skills

Reimbursement knowledge

Payer requirements interpretation

Communication skills

Attention to detail

Team collaboration

Adaptability in small teams

Tools

EMR systems

Microsoft Office

Job description

Inspire Medical Systems is seeking a remote Prior Authorization Specialist in the United States. You will support the company’s Prior Authorization Program and work with Territory Managers to ensure correct coding and coverage decisions.

You will handle patient intake, verify insurance coverage, and pursue authorization success with insurances, patients, and sites. Responsibilities include managing PA requests and related EMR documentation, updating best practices, and guiding appeals and coding