Reimbursement Coordinator II
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Job Description
Reimbursement Coordinator supporting prior authorization and payer coverage for Medtronic neuromodulation therapies. Coordinating documentation, submissions, denials, and provider-office reimbursement workflows.
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
- Monitor authorization status and follow up with provider offices and payers to support timely coverage decisions
- Analyze authorization denials and support reconsideration, resubmission, and appeal activities
- Interpret payer coverage policies, reimbursement requirements, and authorization criteria
- Partner with field personnel and healthcare provider offices to provide guidance on authorization processes and payer requirements
- Maintain accurate case records, reporting data, and reimbursement resources
- Support operational audits, productivity monitoring, and process improvements
Requirements:
- High School Diploma and 2+ years of experience in prior authorization, reimbursement, healthcare revenue cycle, payer operations, insurance verification, or patient access support
- Experience working 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
- Unrestricted U.S. work authorization at the time of hire and for the duration of employment
- Associate's or Bachelor's degree preferred
- American Academy of Professional Coders (AAPC) Coding Certification preferred
- Experience supporting medical device, neuromodulation, or healthcare reimbursement programs preferred
- Knowledge of ICD-10 and Current Procedural Terminology (CPT) coding preferred
- Experience using Salesforce and healthcare reimbursement or patient access platforms preferred
- For Baccalaureate degrees earned outside of the United States, a degree that satisfies the requirements of 8 C.F.R. § 214.2(h)(4)(iii)(A) is required
Benefits:
- Competitive salary and flexible Benefits Package
- Health, Dental and vision insurance
- Health Savings Account
- Healthcare Flexible Spending Account
- Life insurance
- Long-term disability leave
- Dependent daycare spending account
- Tuition assistance/reimbursement
- Simple Steps (global well-being program)
- Incentive plans
- 401(k) plan plus employer contribution and match
- Short-term disability
- Paid time off
- Paid holidays
- Employee Stock Purchase Plan
- Employee Assistance Program
- Non-qualified Retirement Plan Supplement
- Capital Accumulation Plan (available to Vice Presidents and above, or subject to IRS earning minimums)
- Temporary employees are eligible for paid sick time, as required under applicable state law, and the Employee Stock Purchase Plan
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