[Hiring] Prior Authorization Manager @MicroTransponder
Apr 02, 2025 - MicroTransponder is hiring a remote Prior Authorization Manager. đź’¸ Salary: unspecified. đź“ŤLocation: USA.
Role Description
The Prior Authorization Manager is responsible for leading and optimizing the pre-service clearance process to ensure timely access to Vivistim® Paired VNS™ Therapy. Reporting to the Market Access Director, this role will guide prior authorization workflows, payer engagement strategies, and process improvements, serving as a key resource for both internal teams and external stakeholders.
- Lead and refine the prior authorization process, ensuring efficient and accurate submission of authorization requests and appeals.
- Act as a subject matter expert (SME) on prior authorization workflows, payer engagement strategies, and pre-service clearance best practices.
- Monitor and analyze payer authorization trends, identifying opportunities to improve internal processes and payer interactions.
- Serve as an escalation point for complex authorization denials, working with payers and providers to facilitate resolution.
- Collaborate with healthcare providers and revenue cycle teams to address documentation gaps and improve prior authorization success rates.
- Partner with the field sales team to provide guidance on payer requirements and develop strategies to support provider offices in securing approvals.
- Develop and refine training materials and educational programs for internal teams and provider offices on prior authorization best practices and payer requirements.
- Ensure compliance with HIPAA, payer policies, and regulatory requirements in all prior authorization activities.
- Maintain accurate reporting and dashboards, tracking authorization success rates, turnaround times, and payer-specific trends.
- Provide strategic insights to leadership on prior authorization challenges, policy trends, and opportunities for process optimization.
- Work cross-functionally to enhance the overall efficiency and effectiveness of the prior authorization function.
- Other duties as assigned.
Qualifications
- Minimum 8 years of experience in prior authorization, commercial payer policy navigation, or revenue cycle management, preferably in medical device, neurostimulation, or rehabilitation therapies.
- Expertise in prior authorization workflows, commercial payer appeals, and reimbursement processes.
- Strong understanding of commercial insurance plans and their prior authorization requirements.
- Proficiency in CPT, HCPCS, and ICD-10 coding, as well as medical necessity documentation best practices.
- Experience with payer policy review, insurance verification, and authorization tracking systems.
- Strong analytical skills with the ability to interpret payer data, identify trends, and develop strategic recommendations.
- Education: Minimum Bachelor’s degree required.
- Preferred Certifications: CPC or similar coding and revenue cycle certification.
- Experience with Salesforce®, EPIC Systems®, or other EHR/ERP systems is a plus.
Requirements
- Subject Matter Expertise – Serves as a functional leader in prior authorization strategy and payer engagement.
- Strategic Thinking – Identifies opportunities to refine workflows, improve efficiencies, and enhance the authorization process.
- Collaboration – Works cross-functionally with providers, payers, and internal teams to optimize patient access.
- Problem-Solving & Adaptability – Proactively addresses authorization challenges and navigates evolving payer landscapes.
- Process Improvement – Continuously assesses and enhances workflows to drive operational excellence.
Benefits
- Comprehensive benefits program including medical, dental, and vision plans along with an FSA.
- Participation in the company 401(k) plan with company matching.
- Unlimited Paid Time Off (PTO) program.
- Approximately 15 paid company holidays per year.
Company Description
MicroTransponder, Inc. is a privately held medical device development company with a strong neuroscience research focus. An experienced team of scientists and engineers have developed a neurostimulation technology platform to treat neurological conditions, including post-stroke motor rehabilitation and tinnitus.
MicroTransponder is rapidly expanding its team and seeks talented individuals with a passion for stroke rehabilitation and neuromodulation. Please apply via our website at https://microtransponder.com/en-gb/stroke/about/careers .
MicroTransponder is an Equal Opportunity Employer (EOE). All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.
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| đź“Ť | Be aware of the location restriction for this remote position: USA |
| ‼ | Beware of scams! When applying for jobs, you should NEVER have to pay anything. Learn more. |
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Salary
đź’¸
unspecified
|
Remote
Location
USA
|
|
Job Type
full-time
|
Posted
Apr 02, 2025
|
| đź“Ť | Be aware of the location restriction for this remote position: USA |
| ‼ | Beware of scams! When applying for jobs, you should NEVER have to pay anything. Learn more. |
