Patient Access Support Specialist

Medtronic • Minneapolis, MN

2d • Remote

About The Position

At Medtronic you can begin a life-long career of exploration and innovation, while helping champion healthcare access and equity for all. You’ll lead with purpose, breaking down barriers to innovation in a more connected, compassionate world. A Day in the Life The Patient Access Support Specialist for the Coronary Renal Denervation (CRDN) Operating Unit (OU) is responsible for supporting patient access to a new technology by assisting physicians, hospitals, and patients with prior authorization and appeal management. This position will interface with commercial and government payers to ensure patient insurance eligibility and benefits, identify medical necessity requirements for prior approval, and submit for authorization. Ongoing provider education and support is a key part of this role to optimize coverage and reimbursement. This position will also assist in keeping other members of the CRDN Reimbursement team informed on issues and trends in payer coverage decisions. All work will be done within approved guidelines, policies and procedures and will most often be delivered telephonically. At Medtronic, we bring bold ideas forward with speed and decisiveness to put patients first in everything we do. This position is remote to enhance our competitive edge and expand our cross-functional collaboration efforts. This role will require 10% of travel to enhance collaboration and ensure successful completion of projects.

Requirements

• Bachelor's degree
• Minimum of 2 year's experience in case management, prior authorization or utilization review
• Or 0 year's experience in case management, prior authorization or utilization review with an advanced degree

Nice To Haves

• Understanding of healthcare payment processes, reimbursement and coverage issues including medical necessity, denials, and appeals processes.
• Clinical nursing experience preferred
• Familiar with Medtronic reimbursement policies and procedures.
• Excellent written and verbal communication skills and ability to adapt to different audiences
• Exceptional customer service and problem-solving skills with the ability to manage multiple customer requests
• Outstanding organizational skills, including documentation, multi-tasking and prioritizing
• Ability to learn and use multiple CRM software programs as needed
• Knowledge of medical terminology and medical conditions
• Proven relationship-building skills with internal and external stakeholders including physicians, hospital administrators or payers)
• Demonstrated ability to work, collaborate, and influence in a highly matrixed organization
• Proficient with Microsoft Office (Outlook, Word, Excel & PowerPoint)
• High degree of initiative and self-motivation and the ability to direct and motivate others
• Ability to work effectively in a team environment and build strong working relationships
• Travel requirement is less than 10%
• 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.

Responsibilities

• Assist physicians, hospitals, and patients in understanding details of coverage polices, prior authorization, and denial management for renal denervation.
• Validate patient’s insurance coverage and benefits.
• Check the requirements for prior authorization and initiate as requested by customer.
• Coordinate required paperwork and clinical notes for submission in a timely and comprehensive manner as required.
• Follow up frequently with payers to ensure visibility on authorization status throughout the process.
• Relay information and provide timely updates to internal and external stakeholders.
• Upon request, write persuasive appeal letters to address payer objections using provider documentation to support medical necessity.
• Submit appeals in accordance with payer processes and timelines.
• Work within the guidelines, policies and procedures using clinical background, knowledge, and skills.
• Stay up to date and informed on commercial and government payer coverage and prior authorization requirements.
• Create and maintain accurate reporting of payer processes, coverage decisions, issues, and trends.
• Collaborate on the development of relevant materials for physicians, hospitals, and patients.
• Other duties may be assigned as needed.

Benefits

• Medtronic offers a 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, and 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 (subject to IRS earning minimums), and Capital Accumulation Plan (available to Vice Presidents and above, or subject to IRS earning minimums).

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Number of Employees: 5,001-10,000 employees