Prior Authorization Specialist

MicroTransponder • Minneapolis, MN

4h

About The Position

The Prior Authorization Specialist is part of the Market Access & Reimbursement Team and serves as the primary liaison for providers, hospitals, and rehabilitation centers. The Prior Authorization Specialist will oversee the pre-service clearance process, including insurance verification, prior authorizations, and appeals management. The ideal candidate will bring a strong understanding of payer workflows and a commitment to delivering outstanding support to healthcare providers nationwide.

Requirements

• Minimum of 2 years of experience in medical prior authorization, reimbursement, or medical front-office operations.
• Proven success navigating pre-service clearance and payer workflows.
• Experience working with medical records, insurance portals, and patient confidentiality regulations (HIPAA).
• Strong communication, documentation, and organizational skills.
• Ability to adapt in a fast-paced, team-oriented environment.

Nice To Haves

• Experience securing authorization for implantable medical devices, neuromodulation therapies, or rehabilitation services.
• Familiarity with hospital and physician billing processes for Medicare and commercial payers.
• Knowledge of the full revenue cycle, including claims submission, edits, and appeals.
• Proficiency in systems such as Salesforce®, EPIC®, or other EHR/ERP platforms.
• Coding certification (e.g., CPC) or practice management credentials (e.g., RHIA, RHIT).
• Experience working in a startup or growth-stage company.
• Background in neurostimulation or rehabilitation fields.

Responsibilities

• Review insurance coverage policies related to vagus nerve stimulation (VNS) and stroke rehabilitation therapies.
• Contact insurance carriers to verify patient eligibility, benefits, and authorization requirements for Vivistim® Therapy.
• Request, collect, and manage patient medical records across multiple provider offices, ensuring HIPAA compliance.
• Submit and track prior authorization requests within defined timelines.
• Initiate and manage appeals for denied authorizations, including documentation and follow-up.
• Ensure accurate use of CPT, HCPCS, and ICD-10 codes throughout the process.
• Maintain thorough documentation of communications in internal databases and CRM systems.
• Identify trends or changes in payer policies and communicate updates to internal stakeholders.
• Provide support and resources to clinics to appeal denied services, including templates and procedural guidance.
• Respond to provider inquiries related to medical policy, claims status, and authorization processes.
• Apply knowledge of medical terminology and claims workflows to optimize reimbursement processes.
• Perform other duties as assigned to support the broader goals of the Market Access team.

Benefits

• MicroTransponder provides a comprehensive benefits program to employees. It includes medical, dental and vision plans along with an FSA.
• Employees may participate in the company 401(k) plan with company matching.
• The company offers an unlimited Paid Time Off (PTO) program and approximately 15 paid company holidays per year.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: No Education Listed