Job Description

Job Description

Job Description

• Hourly rate: $26.50
• Spots to fill: 3
• Contract: 6 months to start
• Location: Minneapolis
• Work environment: They will be required to come into the office 2 days per month, the days will be suggested based on team meetings but also can be flexible.
• Training period: Day one will start in the office to get through initial onboarding. There may be other required in office training days, but will mostly be from home
• Interview Process: 30 minute virtual with manager
• Start Date: ASAP and they do not have to all start together.
• Top 3 characteristics to look for in a candidate:
  • Previous experience with medical prior authorizations
  • Strong phone skills
  • Strong drive and initiative to work independently through large volume of work each day

Job Description

The Prior Authorization Specialist plays a vital role in the patient order process, navigating complex authorization requirements across multiple health insurance companies (payers). This position is responsible for accurate and timely submission and monitoring of authorization requests, prompt and precise processing of approvals and denials, and securing the necessary documentation is to support favorable claim outcomes. The specialist also educates payers on the features and benefits of our products and collaborates with internal teams and external partners to expedite patient access to our products.

Responsibilities:

• Determine authorization process and requirements of payers for durable medical equipment.
• Review clinician and order documentation for specific elements to satisfy payer authorization and policy requirements.
• Submit and follow up on the status of authorization requests for coverage with commercial payers.
• Effectively educate payers on the features and benefits of the Company’s
• Maintain payer portal registrations and access.
• Maintain an extensive working knowledge and expertise of payer processes.
• Identify and report payer trends.
• Ensure timely processing of orders.
• Maintain department service levels including turnaround time.
• Serve as an expeditor/liaison between Tactile Medical, healthcare teams, and patients to obtain all necessary paperwork to drive order to shipment.
• Update and maintain patient information and database records thoroughly and accurately.
• Be a team player. Assist other team members when needed
• Be a champion for continuous process improvement. Ask questions and continually look for ways to make processes better, faster, or more efficient.
• Contribute to monthly 1:1, small and large group team meetings.
• May participate in training of new team members or field reps, handle product conversions and/or general account support.
• Maintain compliance with internal and external regulations, policies, and procedures for areas of responsibility.
• Other duties as assigned.

Qualifications:

Education & Experience

Required:

• Bachelor’s degree or equivalent and relevant work experience
• 2+ years’ experience in a medical device or payer process or 6+ months of consistent performance with productivity and quality in the POM role

Preferred:

• Previous experience in working with patients, clinicians, and payers.
• Previous experience working with Filemaker or Parachute.
• Previous medical device (outpatient DME), insurance, revenue cycle management, reimbursement, or customer service experience.

Knowledge & Skills

• Ability to accurately enter and review patient order information to ensure data integrity and compliance with established protocols.
• Capacity to effectively prioritize tasks and manage workload to meet deadlines and productivity targets in a fast-paced environment.
• Clear and concise verbal and written communication skills to interact with team members, healthcare professionals, and patients professionally and with empathy.
• Flexibility to adjust to changing priorities, processes, and procedures as required to support the needs of the department and organization.
• Willingness to work collaboratively with colleagues to achieve common goals and provide support as needed to ensure the smooth functioning of the team.
• Ability to identify and resolve routine issues or escalate them appropriately to ensure timely resolution and minimize disruption to order processing workflows.
• Dedication to delivering high-quality service to internal and external customers by addressing inquiries, concerns, and requests promptly and courteously.
• Proficiency in using computer systems and software applications relevant to order management tasks, with a willingness to learn and adapt to new technologies as needed.
• Understanding of and commitment to adhering to relevant regulations, policies, and procedures governing patient order management activities.
• Demonstrated professionalism and integrity in handling confidential patient information and representing the organization positively in all interactions.

Based in Eagan, MN. C4 Technical Services has been a national provider of contingent workforce solutions since 2003.
Women and Minority owned – NMSDC Certified
Offices in MN (Corporate), TX, CA

Company Description

Based in Eagan, MN. C4 Technical Services has been a national provider of contingent workforce solutions since 2003.\r\nWomen and Minority owned – NMSDC Certified\r\nOffices in MN (Corporate), TX, CA

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