Remote Prior Authorization & Reimbursement Coordinator II

Medtronic plc; 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

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