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Prior Authorization Specialist jobs in United States
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CVRx | Barostim · 11 hours ago

Prior Authorization Specialist

CVRx, Inc. is a pioneer in unique therapies that enhance the body’s natural systems, striving to improve healthcare. The Prior Authorization Specialist plays a critical role in managing prior authorizations and appeals, ensuring seamless access to care and effective communication with insurance representatives.
BiotechnologyHealth CareHealth DiagnosticsMedicalMedical Device
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Growth Opportunities

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

Qualification

Prior authorization experienceReimbursement knowledgeMedical terminology knowledgeCritical thinkingProblem solvingIndependenceDependabilityWritten communicationVerbal communicationAttention to detail

Required

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

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

Benefits

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

Company

CVRx | Barostim

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CVRx is a commercial stage, public (NASDAQ: CVRX) medical devices company located in Minneapolis, Minnesota.

Funding

Current Stage
Public Company
Total Funding
$390.6M
Key Investors
Treo Ventures,Vensana CapitalJohnson & Johnson Development CorporationOxford Finance LLC
2021-06-29IPO
2020-07-07Private Equity· $50M
2019-08-09Series G· $93M

Leadership Team

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Robert John
Chief Revenue Officer (CRO)
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Company data provided by crunchbase