Remote Prior Authorization Specialist (Reimbursement)

Inspire Medical Systems Inc.; United States; Remote; USD 50,000 - 70,000; Full time

Benefits offered by this job

Remote work

Flexible time off

Tuition reimbursement

Job summary

Inspire Medical Systems seeks a Prior Authorization Specialist to implement the U.S. Prior Authorization Program. You’ll collaborate with Territory Managers and the prior authorization team to resolve coding and coverage questions, manage patient data, and pursue EMR success.

Key duties include handling insurance verifications, managing authorization requests, and training sites on program requirements. A Bachelor’s degree and 2+ years in reimbursement are preferred.

Qualifications

• 2+ years of reimbursement-related work experience.
• 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 environment.

Responsibilities

• Enter and manage patient information in database.
• Assist with patient intake and verify insurance coverage.
• Call insurances to obtain the status of prior authorization requests.
• Work with patients and sites to pursue authorization success.
• Track progress of prior authorization requests and related appeals through EMR.
• Update materials and best practices for prior authorization and EMR processes.
• Seek continuous process improvement to increase success rates.
• Train sites on program requirements and provide guidance on appeals.

Skills

Reimbursement knowledge

Payer requirements interpretation

Clinical literature summarization

Communication skills

MS Office proficiency

Attention to detail

Team collaboration

Adaptability

Education

Bachelor’s degree

Job description

Inspire Medical Systems seeks a Prior Authorization Specialist to implement the U.S. Prior Authorization Program. You’ll collaborate with Territory Managers and the prior authorization team to resolve coding and coverage questions, manage patient data, and pursue EMR success.

Key duties include handling insurance verifications, managing authorization requests, and training sites on program requirements. A Bachelor’s degree and 2+ years in reimbursement are preferred.