Prior Authorization Specialist

Inspire Medical Systems

. Provide expertise in prior authorization and implement the Inspire Prior Authorization Program in the United States .

Posted 10/31/2026full-timeRemote • Minnesota • United StatesJuniorMid-Level💰 $50,000 - $70,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in prior authorization processes and reimbursement compliance, with a strong focus on patient management and effective communication with insurance providers. Proven ability to implement programs, train teams, and improve operational efficiencies in a dynamic healthcare environment.

Highest-signal resume keywords

Prior Authorization ExpertiseReimbursement Compliance KnowledgePatient ManagementMicrosoft Office ProficiencyMedical Device Experience

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Prior AuthorizationReimbursementCoding InformationPatient IntakeInsurance VerificationExternal Medical Review (EMR)Process ImprovementData ManagementClinical Literature InterpretationAction Plan Execution

Soft Skills

Excellent Communication SkillsAttention to DetailTeam CollaborationIntegrityAdaptability

Tools & Technologies

Microsoft WordMicrosoft PowerPointMicrosoft ExcelDatabase Management

Industry Keywords

HealthcareReimbursement EnvironmentPrior Authorization ProgramInsurance ProvidersPatient Success

About the role

Key responsibilities & impact

Provide expertise in prior authorization and implement the Inspire Prior Authorization Program in the United States
Work with Territory Managers and the prior authorization team to answer coding and coverage questions
Enter and manage patient information in databases
Assist with patient intake and verify insurance coverage
Call insurance providers to obtain prior authorization request status
Work with patients and sites to pursue authorization success
Track and monitor prior authorization requests and related appeals through External Medical Review (EMR)
Update materials and best practices supporting prior authorization and appeals processes
Seek continuous process improvement to increase success rates and reduce time to success
Train sites on program requirements
Complete prior authorization requests
Provide guidance to sites on appeals, including EMR
Work directly with patients to pursue EMR success
Provide general coding information to physician customers
Execute action plans and objectives with managers and staff to support internal/external clients
Document product and therapy-related field reports and provide follow-up reporting
Complete required training and competency confirmations
Comply with quality system procedures and policies

Requirements

What you’ll need

2+ years of related work experience in reimbursement
Demonstrated knowledge of reimbursement compliance requirements
High level of personal integrity to promote a compliant reimbursement environment
Ability to read, interpret and appropriately respond to payer requirements relating to prior authorization
Ability to read, interpret and summarize clinical and cost literature
Excellent written and oral communication skills
Proficient in Microsoft Office applications, including Word, PowerPoint, Excel
High attention to detail and strong team attitude
Comfortable in a small, dynamic company environment with frequent changes in direction
Bachelor’s degree preferred
Medical device experience preferred

Benefits

Comp & perks

Excellent benefits
401k matching
Employee Stock Purchase Program (ESPP)
Flexible time off (FTO)
Tuition reimbursement
Multiple health insurance plan options
Employer contributions to Health Savings Account
Dental, Vision, Life and Disability benefits
401k plan + employer match
Identity Protection
Employee Assistance program
Equity awards
Employee Stock Purchase Program