Reimbursement Coordinator II

About Medtronic

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.

Job Summary

The Reimbursement Coordinator is responsible for verifying prior authorization requirements and obtaining authorization when required. Works directly with physician offices and payers to facilitate patient access to various therapies. The representative will ensure patient insurance coverage and benefits, identify requirements for prior approval, and submit for authorization. Assists with appealing prior authorization denials, retro authorization, or other special cases.

Key Responsibilities

• Validates insurance patient’s coverage, communicates any issues with benefits or coverage to the appropriate managers
• Checks the requirements for prior authorization and initiates as required
• Coordinates required paperwork, clinical notes, and forms for submission to support requests and initiates as required
• Follows up frequently to ensure visibility on authorization status throughout the approval process
• Basic knowledge of the payer payment process, with detailed knowledge of the payer prior authorization process
• Basic ICD9/10 and CPT code familiarity, expert knowledge on a subset of Medtronic therapy codes
• Superior customer service skills with outstanding communication skills to use with various stakeholders: physicians, sales representatives, payer representatives, utilization reviewers, and various internal and external stakeholders
• Advanced Microsoft Excel skills
• Ability to learn and use multiple CRM software programs as needed
• Good organizational skills with the ability to handle multiple inquiries at the same time, and critical problem-solving skills with high attention to detail

Requirements

• Minimum of 2 years of relevant experience

Preferred Qualifications

• 4 years of experience
• AAPC Coding Certificate
• College Degree
• Sales Force User
• Customer Service Experience

Physical Job Requirements

The above statements are intended to describe the general nature and level of work being performed by employees assigned to this position, but they are not an exhaustive list of all the required responsibilities and skills of this position.