Prior Authorization Specialist

<meta><p style="font-family:&quot;Basel Grotesk&quot;,Arial,sans-serif;font-size:11pt;font-weight:400;line-height:1.6;letter-spacing:0.25px;margin:4px 0px;padding:0px;"><br></p><p style="font-family:&quot;Basel Grotesk&quot;,Arial,sans-serif;font-size:15pt;font-weight:400;line-height:1.6;letter-spacing:0.25px;margin:4px 0px;padding:0px;"><b><strong style="font-size:15pt;white-space:pre-wrap;">About the role</strong></b></p><p style="font-family:&quot;Basel Grotesk&quot;,Arial,sans-serif;font-size:15pt;font-weight:400;line-height:1.6;letter-spacing:0.25px;margin:4px 0px;padding:0px;"><br></p><p style="font-family:&quot;Basel Grotesk&quot;,Arial,sans-serif;font-size:11pt;font-weight:400;line-height:1.6;letter-spacing:0.25px;margin:4px 0px;padding:0px;"><span style="white-space:pre-wrap;">The Prior Authorization Specialist is part of the Market Access &amp; Reimbursement Team and serves as the primary liaison for providers, hospitals, and rehabilitation centers. The Prior Authorization Specialist will oversee the pre-service clearance process, including insurance verification, prior authorizations, and appeals management. The ideal candidate will bring a strong understanding of payer workflows and a commitment to delivering outstanding support to healthcare providers nationwide.</span></p><p style="font-family:&quot;Basel Grotesk&quot;,Arial,sans-serif;font-size:15pt;font-weight:400;line-height:1.6;letter-spacing:0.25px;margin:4px 0px;padding:0px;"><br></p><p style="font-family:&quot;Basel Grotesk&quot;,Arial,sans-serif;font-size:8pt;font-weight:400;line-height:1.6;letter-spacing:0.25px;margin:4px 0px;padding:0px;"><b><strong style="font-size:15pt;white-space:pre-wrap;">What you'll do</strong></b></p><ul data-pattern="discCircleSquare" data-depth="1" style="font-family:&quot;Basel Grotesk&quot;,Arial,sans-serif;font-size:11pt;font-weight:400;margin:8px 0px;line-height:1.6;padding:0px 0px 0px 32px;list-style-type:disc;"><li style="font-size:12pt;margin:3px 0px;letter-spacing:0.25px;line-height:1.6;"><span style="white-space:pre-wrap;">Review insurance coverage policies related to vagus nerve stimulation (VNS) and stroke rehabilitation therapies.</span></li><li style="font-size:12pt;margin:3px 0px;letter-spacing:0.25px;line-height:1.6;"><span style="white-space:pre-wrap;">Contact insurance carriers to verify patient eligibility, benefits, and authorization requirements for Vivistim® Therapy.</span></li><li style="font-size:12pt;margin:3px 0px;letter-spacing:0.25px;line-height:1.6;"><span style="white-space:pre-wrap;">Request, collect, and manage patient medical records across multiple provider offices, ensuring HIPAA compliance.</span></li><li style="font-size:12pt;margin:3px 0px;letter-spacing:0.25px;line-height:1.6;"><span style="white-space:pre-wrap;">Submit and track prior authorization requests within defined timelines.</span></li><li style="font-size:12pt;margin:3px 0px;letter-spacing:0.25px;line-height:1.6;"><span style="white-space:pre-wrap;">Initiate and manage appeals for denied authorizations, including documentation and follow-up.</span></li><li style="font-size:12pt;margin:3px 0px;letter-spacing:0.25px;line-height:1.6;"><span style="white-space:pre-wrap;">Ensure accurate use of CPT, HCPCS, and ICD-10 codes throughout the process.</span></li><li style="font-size:12pt;margin:3px 0px;letter-spacing:0.25px;line-height:1.6;"><span style="white-space:pre-wrap;">Maintain thorough documentation of communications in internal databases and CRM systems.</span></li><li style="font-size:12pt;margin:3px 0px;letter-spacing:0.25px;line-height:1.6;"><span style="white-space:pre-wrap;">Identify trends or changes in payer policies and communicate updates to internal stakeholders.</span></li><li style="font-size:12pt;margin:3px 0px;letter-spacing:0.25px;line-height:1.6;"><span style="white-space:pre-wrap;">Provide support and resources to clinics to appeal denied services, including templates and procedural guidance.</span></li><li style="font-size:12pt;margin:3px 0px;letter-spacing:0.25px;line-height:1.6;"><span style="white-space:pre-wrap;">Respond to provider inquiries related to medical policy, claims status, and authorization processes.</span></li><li style="font-size:12pt;margin:3px 0px;letter-spacing:0.25px;line-height:1.6;"><span style="white-space:pre-wrap;">Apply knowledge of medical terminology and claims workflows to optimize reimbursement processes.</span></li><li style="font-size:12pt;margin:3px 0px;letter-spacing:0.25px;line-height:1.6;"><span style="white-space:pre-wrap;">Perform other duties as assigned to support the broader goals of the Market Access team.</span></li></ul><p style="font-family:&quot;Basel Grotesk&quot;,Arial,sans-serif;font-size:8pt;font-weight:400;line-height:1.6;letter-spacing:0.25px;margin:4px 0px;padding:0px;"><b><strong style="font-size:15pt;white-space:pre-wrap;">Qualifications</strong></b></p><ul data-pattern="discCircleSquare" data-depth="1" style="font-family:&quot;Basel Grotesk&quot;,Arial,sans-serif;font-size:11pt;font-weight:400;margin:8px 0px;line-height:1.6;padding:0px 0px 0px 32px;list-style-type:disc;"><li style="font-size:12pt;margin:3px 0px;letter-spacing:0.25px;line-height:1.6;"><span style="white-space:pre-wrap;">Minimum of 2 years of experience in medical prior authorization, reimbursement, or medical front-office operations.</span></li><li style="font-size:12pt;margin:3px 0px;letter-spacing:0.25px;line-height:1.6;"><span style="white-space:pre-wrap;">Proven success navigating pre-service clearance and payer workflows.</span></li><li style="font-size:12pt;margin:3px 0px;letter-spacing:0.25px;line-height:1.6;"><span style="white-space:pre-wrap;">Experience working with medical records, insurance portals, and patient confidentiality regulations (HIPAA).</span></li><li style="font-size:12pt;margin:3px 0px;letter-spacing:0.25px;line-height:1.6;"><span style="white-space:pre-wrap;">Strong communication, documentation, and organizational skills.</span></li><li style="font-size:12pt;margin:3px 0px;letter-spacing:0.25px;line-height:1.6;"><span style="white-space:pre-wrap;">Ability to adapt in a fast-paced, team-oriented environment.</span></li><li style="font-size:12pt;margin:3px 0px;letter-spacing:0.25px;line-height:1.6;"><span style="white-space:pre-wrap;">Experience securing authorization for implantable medical devices, neuromodulation therapies, or rehabilitation services.</span></li><li style="font-size:12pt;margin:3px 0px;letter-spacing:0.25px;line-height:1.6;"><span style="white-space:pre-wrap;">Familiarity with hospital and physician billing processes for Medicare and commercial payers.</span></li><li style="font-size:12pt;margin:3px 0px;letter-spacing:0.25px;line-height:1.6;"><span style="white-space:pre-wrap;">Knowledge of the full revenue cycle, including claims submission, edits, and appeals.</span></li><li style="font-size:12pt;margin:3px 0px;letter-spacing:0.25px;line-height:1.6;"><span style="white-space:pre-wrap;">Proficiency in systems such as Salesforce®, EPIC®, or other EHR/ERP platforms.</span></li><li style="font-size:12pt;margin:3px 0px;letter-spacing:0.25px;line-height:1.6;"><span style="white-space:pre-wrap;">Coding certification (e.g., CPC) or practice management credentials (e.g., RHIA, RHIT).</span></li><li style="font-size:12pt;margin:3px 0px;letter-spacing:0.25px;line-height:1.6;"><span style="white-space:pre-wrap;">Experience working in a startup or growth-stage company.</span></li><li style="font-size:12pt;margin:3px 0px;letter-spacing:0.25px;line-height:1.6;"><span style="white-space:pre-wrap;">Background in neurostimulation or rehabilitation fields.</span></li></ul><p style="font-family:&quot;Basel Grotesk&quot;,Arial,sans-serif;font-size:11pt;font-weight:400;line-height:1.6;letter-spacing:0.25px;margin:4px 0px;padding:0px;"><br></p><p style="font-family:&quot;Basel Grotesk&quot;,Arial,sans-serif;font-size:15pt;font-weight:400;line-height:1.6;letter-spacing:0.25px;margin:4px 0px;padding:0px;text-align:start;"><b><strong style="font-size:15pt;white-space:pre-wrap;">Equal Opportunity Employer</strong></b></p><p style="font-family:&quot;Basel Grotesk&quot;,Arial,sans-serif;font-size:12pt;font-weight:400;line-height:1.6;letter-spacing:0.25px;margin:4px 0px;padding:0px;text-align:start;"><span style="white-space:pre-wrap;">MicroTransponder, Inc. provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.</span></p><p style="font-family:&quot;Basel Grotesk&quot;,Arial,sans-serif;font-size:15pt;font-weight:400;line-height:1.6;letter-spacing:0.25px;margin:4px 0px;padding:0px;text-align:start;"><b><strong style="font-size:15pt;white-space:pre-wrap;">Benefits</strong></b></p><p style="font-family:&quot;Basel Grotesk&quot;,Arial,sans-serif;font-size:11pt;font-weight:400;line-height:1.6;letter-spacing:0.25px;margin:4px 0px;padding:0px;text-align:start;"><span style="white-space:pre-wrap;">MicroTransponder provides a comprehensive benefits program to employees.&nbsp; It includes medical, dental and vision plans along with an FSA.&nbsp; Employees may participate in the company 401(k) plan with company matching.&nbsp; The company offers an unlimited Paid Time Off (PTO) program and approximately 15 paid company holidays per year.</span></p> <meta><p style="font-family:&quot;Basel Grotesk&quot;,Arial,sans-serif;font-size:8pt;font-weight:400;line-height:1.6;letter-spacing:0.25px;margin:4px 0px;padding:0px;"><b><strong style="font-size:15pt;white-space:pre-wrap;">About MicroTransponder</strong></b></p><p style="font-family:&quot;Basel Grotesk&quot;,Arial,sans-serif;font-size:11pt;font-weight:400;line-height:1.6;letter-spacing:0.25px;margin:4px 0px;padding:0px;text-align:start;"><span style="white-space:pre-wrap;">MicroTransponder, Inc. is dedicated to transforming the lives of stroke survivors through its innovative neurostimulation technology. The company's flagship product, the FDA-approved Vivistim® Paired VNS™ System, enhances stroke rehabilitation by pairing vagus nerve stimulation (VNS) with physical and occupational therapy. This approach leverages the brain's neuroplasticity to improve upper limb function, offering new hope to those with chronic arm and hand impairments following an ischemic stroke.</span></p><p style="font-family:&quot;Basel Grotesk&quot;,Arial,sans-serif;font-size:11pt;font-weight:400;line-height:1.6;letter-spacing:0.25px;margin:4px 0px;padding:0px;text-align:start;"><span style="white-space:pre-wrap;">By integrating this therapy into rehabilitation programs, MicroTransponder aims to help stroke survivors regain independence in daily activities and enhance their quality of life. The company's commitment to advancing stroke recovery is evident in its ongoing research and collaboration with healthcare providers to make this therapy accessible to more patients.</span></p>