Careers that Change LivesWe seek out and hire a diverse workforce at every level: We need fresh ideas and inclusive insights to continue to be an innovative industry leader — that’s why we make it a point to seek out, attract, and develop employees who are patient-centric, passionate, and who represent the same wide variety of life experiences as our patients.Medtronic pioneered the field of neuromodulation with the first commercially available spinal cord stimulator to treat chronic pain and engineered the first deep brain stimulation (DBS) system to treat movement disorders and the first implantable drug pump to deliver medication directly to the intrathecal space of the spine. More than 40 years later, we continue to innovate, constantly challenging ourselves to disrupt the markets we created. We advance science by thinking and acting boldly, bringing together the right people with the right breadth of expertise to engineer groundbreaking therapies and technologies.A Day in the LifeThe Prior Authorization Representative is responsible for verifying prior authorization requirements and obtaining authorization when required. Works directly with physician offices and payers to facilitate patient access to various therapies. The representative will ensure patient insurance coverage and benefits, identify requirements for prior approval, and submit for authorization. Assists with appealing prior authorization denials, retro authorization, or other special cases.Responsibilities may include the following, as well as other duties that may be assigned.
Validate insurance patient’s coverage and communicate any issues with benefits or coverage to the appropriate managers.
Checks the requirements for prior authorization and initiates as required
Coordinates required paperwork, clinical notes, and forms for submission to support requests and initiates as required
Follows up frequently to ensure visibility on authorization status throughout the approval process
Basic knowledge of the payer payment process with detailed knowledge of the payer prior authorization process
Basic ICD9/10 and CPT code familiarity, expert knowledge on a subset of Medtronic therapy codes
Superior customer service skills with outstanding communication skills to use with various stakeholders: physicians, sales representatives, payer representatives, utilization reviewers, various internal and external stakeholders,
Advanced Microsoft Excel skills. Ability to learn and use multiple CRM software programs as needed
Good organizational skills with ability to handle multiple inquiries at the same time and critical problem-solving skills with high attention to detail
Must Have: Minimum Requirements
Minimum of 2 years of relevant experience
Nice to Have
AAPC Coding Certificate
College Degree
Sales Force User
Customer Service Experience
About MedtronicTogether, we can change healthcare worldwide. At Medtronic, we push the limits of what technology, therapies, and services can do to help alleviate pain, restore health, and extend life. We challenge ourselves and each other to make tomorrow better than yesterday. It is what makes this an exciting and rewarding place to be.We want to accelerate and advance our ability to create meaningful innovations - but we will only succeed with the right people on our team. Let’s work together to address universal healthcare needs and improve patients’ lives. Help us shape the future.Physical Job RequirementsThe physical demands described within the Responsibilities section of this job description are representative of those that must be met by an employee to perform the essential functions of this job successfully. Reasonable accommodations may be made to enable individuals with disabilities to perform essential functions. For Office Roles: While performing the duties of this job, the employee is regularly required to be independently mobile. Employees must also interact with a computer and communicate with peers and co-workers. Contact your manager, recruiter, or local HR representative to understand the work conditions and physical requirements that may be specific to each role. (ADA-United States of America)A commitment to our employees' lives is at the core of our values. We recognize their contributions. They share in the success they help to create. We offer many benefits, resources, and competitive compensation plans to support you at every career and life stage. Learn more about our benefits here (https://www3.benefitsolver.com/benefits/BenefitSolverView?pagename=signon&conum=30601&coaffid=medtronic) .This position is eligible for a short-term incentive plan. Learn more about Medtronic Incentive Plan (MIP) here .The provided base salary range is used nationally in the United States (except in Puerto Rico and specific CA locations). The rate offered complies with federal/local regulations and may vary by experience, certification/education, market conditions, location, etc.Min Salary38000Max Salary57000It is the policy of Medtronic to provide equal employment opportunity (EEO) to all persons regardless of age, color, national origin, citizenship status, physical or mental disability, race, religion, creed, gender, sex, sexual orientation, gender identity and/or expression, genetic information, marital status, status with regard to public assistance, veteran status, or any other characteristic protected by federal, state or local law. In addition, Medtronic will provide reasonable accommodations for qualified individuals with disabilities.