Remote Prior Authorization Specialist (Healthcare Reimbursement)

Inspire Medical Systems I; Golden Valley (MN); Remote; USD 50,000 - 70,000; Full time

Benefits offered by this job

Health Insurance

HSA contributions

Dental Insurance

Vision Insurance

Life and Disability Insurance

401k with employer match

Tuition Reimbursement

Employee Assistance program

Equity opportunities

Job summary

Inspire Medical Systems seeks a Prior Authorization Specialist to implement our Prior Authorization Program across the United States. You will coordinate with Territory Managers and the prior authorization team to ensure accurate coding and coverage decisions.

Responsibilities include patient data handling, insurance verification, and pursuing authorization success, with opportunities to improve processes and training for sites. This is a fully remote position with competitive benefits.

Qualifications

• 2+ years of related work experience in reimbursement.
• Knowledge of reimbursement compliance requirements.
• Ability to read, interpret and respond to payer requirements for prior authorization.
• Ability to read, interpret and summarize clinical and cost literature.
• Excellent written and oral communication skills.
• Proficient in Microsoft Office applications (Word, PowerPoint, Excel).
• High attention to detail and strong team attitude.
• Comfortable in a small, dynamic company with frequent changes.

Responsibilities

• Support Inspire’s Prior Authorization Program, including entering and managing patient information in database.
• Assist with patient intake and verifying insurance coverage.
• Call insurances to obtain status of Prior authorization requests.
• Work with patients and sites to pursue authorization success.
• Track and monitor progress of prior authorization requests and related appeals through EMR.
• Update materials and best practices for prior authorization and appeals processes (EMR for upper airway stimulation).
• Pursue process improvements to increase success rates and reduce time to approval.
• Provide guidance to sites on all levels of appeals including EMR.
• Work with physicians to provide general coding information.
• Collaborate with manager and staff to execute action plans.

Skills

Reimbursement experience

Payer requirements interpretation

Clinical and cost literature summar**

Tools

Microsoft Word

PowerPoint

Excel

Job description

Inspire Medical Systems seeks a Prior Authorization Specialist to implement our Prior Authorization Program across the United States. You will coordinate with Territory Managers and the prior authorization team to ensure accurate coding and coverage decisions.

Responsibilities include patient data handling, insurance verification, and pursuing authorization success, with opportunities to improve processes and training for sites. This is a fully remote position with competitive benefits.