The Prior Authorization Specialist manages prior authorizations and appeals, communicates with insurance representatives, ensures accurate documentation, and oversees onboarding for new sites.
Why work for CVRx?
CVRx pioneers' unique therapies that harness and harmonize the body’s natural systems, benefiting society and making CVRx a universal role model in healthcare. We value our commitments to others and continue to overcome challenges through determination, collaboration and purpose. If our culture and values speak to you, and if you have a passion for cutting-edge medical technologies, join our team and our mission to help others live better lives.
A day in the life:
As the Prior Authorization Specialist, you will play a critical role in driving seamless access to care by managing internal prior authorizations, reauthorizations, and appeals with precision and efficiency. This position ensures timely authorizations, maintains accurate documentation of payer information and consumer status, and liaises directly with insurance representatives to navigate complex cases. Occasionally, the specialist will engage directly with consumers to provide guidance and support.
In this dynamic role, the Prior Authorization Specialist also leads the onboarding process for new sites joining the CVRx Prior Authorization Service, oversees multiple cases simultaneously, and keeps the sales team informed of case progress, ensuring transparency and efficiency at every stage. This is a key position for someone who thrives in a fast-paced environment and is passionate about making a meaningful impact in the healthcare space.
KEY DUTIES AND RESPONSIBILITIES
Managing Barostim prior authorizations:
- Accurately entering and maintaining consumer information in the database.
- Assisting with consumer intake and verifying insurance coverage.
- Communicating with insurance companies to track the status of authorization requests.
- Collaborating with consumers and sites to achieve successful authorizations.
- Driving process improvement: Continuously refining workflows to boost success rates and accelerate authorization timelines.
- Strategic collaboration: Partnering with the manager and HCA team to execute effective action plans and objectives.
- Onboarding and updates: Streamlining the onboarding of new sites and providing timely case updates to sales teams.
- Navigating payer requirements: Interpreting and responding to payer guidelines to ensure compliance and maximize outcomes.
REQUIRED EDUCATIONAL / TRAINING / JOB-RELATED EXPERIENCE
- High School Diploma required
- Previous demonstrable prior authorization and reimbursement experience in a highly regulated environment (i.e. healthcare, medical device, etc.)
- Knowledge of medical and claims processing terminology
- Superior written/verbal communication, including an ability to provide clear instructions to non-clinical individuals
- Strong critical thinking and problem solving skills
- Comfortable working in a small, growth stage company with a dynamic environment and frequent changes in direction
- Knowledge of reimbursement compliance requirements and ability to maintain a high level of personal integrity to promote a compliant reimbursement environment
- Dependable, communicative and eager to help patients get the support they need
- Must be able to work independently with high attention to detail and processes and ability to prioritize
- Fast and reliable high-speed internet access
- Professional, private home-office setting required
PREFERRED EDUCATIONAL / TRAINING / JOB-RELATED EXPERIENCE
- Bachelor’s degree or four (4) or more years of relevant experience in prior authorization and appeal requests.
- Prior experience in a small, growth-stage company prone to frequent pivoting
- Experience modifying and updating processes and systems for the purpose of improving program effectiveness.
WORKING CONDITIONS
- Normal Remote working conditions
- Professional home-office environment with privacy
What we offer:
CVRx is proud to offer competitive salaries and benefits plans.
We offer a culture of teamwork, collaboration, and positivity, where challenging the status quo is welcomed, continuous learning is valued, and each of us has an opportunity to make a significant impact in an exciting, purpose-driven startup environment while also having fun.
Salary (or Hourly) range for U.S locations (USD): 72,000 PER YEAR
The base salary range is applicable across the U.S., complies with federal and local regulations and may vary based on factors such as experience, certification/education, market conditions, and specific location.
We also offer a competitive benefits package, details listed below:
Competitive Health & Dental Insurance options with generous Company contributions
Company contributions to an HSA with a high deductible insurance plan selection
401(k) with a company match
Employee stock purchase plan & stock option grants
12 company-paid holidays per year in addition to Flex PTO
Generous paid time off for new parents
Company-paid life insurance & disability options
Unlimited growth opportunities
Training & learning opportunities
Flexible Schedules
EEO statement
CVRx, Inc. provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws.
This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training.
If you're an independent, self-motivated individual with excellent interpersonal skills, a desire to do great things and a have a background in medical devices, healthcare or a related field, we want to hear from you!
If you need assistance or an accommodation due to a disability, you may contact us at [email protected]
This requisition will be open until filled.
Top Skills
Medical And Claims Processing Terminology
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