At Medtronic you can begin a life-long career of exploration and innovation while helping champion healthcare access and equity for all. Youll lead with purpose breaking down barriers to innovation in a more connected compassionate world.

A Day in the Life

The Patient Access Support Specialistfor the Coronary Renal Denervation (CRDN) Operating Unit (OU) is responsible for supporting patient access to a new technology by assisting physicians hospitals and patients with prior authorization and appeal management. This position will interface with commercial and government payers to ensure patient insurance eligibility and benefits identify medical necessity requirements for prior approval and submit for authorization. Ongoing provider education and support is a key part of this role to optimize coverage and reimbursement. This position will also assist in keeping other members of the CRDN Reimbursement team informed on issues and trends in payer coverage decisions. All work will be done within approved guidelines policies and procedures and will most often be delivered telephonically.

Responsibilities:

• Assist physicians hospitals and patients in understanding details of coverage polices prior authorization and denial management for renal denervation.
• Validate patients insurance coverage and benefits.
• Check the requirements for prior authorization and initiate as requested by customer.
• Coordinate required paperwork and clinical notes for submission in a timely and comprehensive manner as required.
• Follow up frequently with payers to ensure visibility on authorization status throughout the process.
• Relay information and provide timely updates to internal and external stakeholders.
• Upon request write persuasive appeal letters to address payer objections using provider documentation to support medical necessity. Submit appeals in accordance with payer processes and timelines.
• Work within the guidelines policies and procedures using clinical background knowledge and skills.
• Stay up to date and informed on commercial and government payer coverage and prior authorization requirements.
• Create and maintain accurate reporting of payer processes coverage decisions issues and trends.
• Collaborate on the development of relevant materials for physicians hospitals and patients.
• Other duties may be assigned as needed.

Very strong preference to have candidates working hybrid from Mounds View MN. Could consider remote from the U.S. for the right candidate.

Must Have; Minimum Requirements

• Bachelors degree

• Minimum of 2 years experience in case management prior authorization or utilization review
• Or 0 years experience in case management prior authorization or utilization review with an advanced degree

Nice To Have

• Understanding of healthcare payment processes reimbursement and coverage issues including medical necessity denials and appeals processes.
• Clinical nursing experience preferred
• Familiar with Medtronic reimbursement policies and procedures.
• Excellent written and verbal communication skills and ability to adapt to different audiences
• Exceptional customer service and problem-solving skills with the ability to manage multiple customer requests
• Outstanding organizational skills including documentation multi-tasking and prioritizing
• Ability to learn and use multiple CRM software programs as needed
• Knowledge of medical terminology and medical conditions
• Proven relationship-building skills with internal and external stakeholders including physicians hospital administrators or payers)
• Demonstrated ability to work collaborate and influence in a highly matrixed organization
• Proficient with Microsoft Office (Outlook Word Excel & PowerPoint)
• High degree of initiative and self-motivation and the ability to direct and motivate others
• Ability to work effectively in a team environment and build strong working relationships
• Travel requirement is less than 10%

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.

The physical demands described within the Responsibilities section of this job description are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. For Office Roles: While performing the duties of this job the employee is regularly required to be independently mobile. The employee is also required to interact with a computer and communicate with peers and co-workers. Contact your manager or local HR to understand the Work Conditions and Physical requirements that may be specific to each role.

Benefits & Compensation

Medtronic offers a competitive Salary and flexible Benefits Package
A commitment to our employees lives at the core of our values. We recognize their contributions. They share in the success they help to create. We offer a wide range of benefits resources and competitive compensation plans designed to support you at every career and life stage.

The following benefits and additional compensation are available to those regular employees who work 20 hours per week: Health Dental and vision insuranceHealth Savings AccountHealthcare Flexible Spending AccountLife insurance Long-term disability leaveDependent daycare spending accountTuition assistance/reimbursement andSimple Steps (global well-being program).

The following benefits and additional compensation are available to all regular employees:Incentive plans 401(k) plan plus employer contribution and matchShort-term disabilityPaid time offPaid holidaysEmployee Stock Purchase PlanEmployee Assistance ProgramNon-qualified Retirement Plan Supplement (subject to IRS earning minimums) andCapital Accumulation Plan (available to Vice Presidents and above or subject to IRS earning minimums).

Regular employees are those who are not temporary such as interns. Temporary employees are eligible for paid sick time as required under applicable state law and the Employee Stock Purchase Plan. Please note some of the above benefits may not apply to workers in Puerto Rico.

Further details are available at the link below:

Medtronic benefits and compensation plans

About Medtronic

We lead global healthcare technology and boldly attack the most challenging health problems facing humanity by searching out and finding solutions.
Our Mission to alleviate pain restore health and extend life unites a global team of 95000 passionate people.
We are engineers at heart putting ambitious ideas to work to generate real solutions for real people. From the R&D lab to the factory floor to the conference room every one of us experiments creates builds improves and solves. We have the talent diverse perspectives and guts to engineer the extraordinary.

Learn more about our business mission and our commitment to diversity here.

It is the policy of Medtronic to provide equal employment opportunity (EEO) to all persons regardless of age color national origin citizenship status physical or mental disability race religion creed gender sex sexual orientation gender identity and/or expression genetic information marital status status with regard to public assistance veteran status or any other characteristic protected by federal state or local addition Medtronic will provide reasonable accommodations for qualified individuals with disabilities.