Prior Authorization Specialist

This is a Fully Remote Job About Our Client:The organization operates in the medical device sector focusing on treatment for Obstructive Sleep Apnea (OSA). It addresses the challenge faced by patients who cannot tolerate or benefit consistently from CPAP therapy by providing an FDA-approved device designed to reduce OSA severity. The company emphasizes patient outcomes and integrity in its approach. About the Opportunity:The PRIOR AUTHORIZATION SPECIALIST role is responsible for implementing and managing the organization's prior authorization program for its medical device in the United States. This position ensures accurate handling of coding and coverage inquiries, supports patient intake and insurance verification, coordinates with internal teams, and advances authorization success to facilitate patient access to treatment. Responsibilities:Support and implement the Prior Authorization Program.Manage patient information within the database.Verify insurance coverage and assist with patient intake.Contact insurance providers to obtain prior authorization status.Collaborate with patients and sites to achieve authorization.Track and monitor prior authorization requests and related appeals through to external medical review.Update materials and best practices for authorization and appeals processes.Train sites on program requirements.Provide coding information to physician customers as needed.Contribute to action plans supporting internal and external clients.Document and report product and therapy-related field issues per quality system requirements.Complete required training and comply with quality system procedures. Requirements:Minimum 2 years experience in reimbursement.Knowledge of reimbursement compliance and high personal integrity.Ability to interpret payer requirements related to prior authorization.Ability to summarize clinical and cost literature.Strong written and oral communication skills.Proficiency with Microsoft Office applications.Attention to detail and team-oriented.Adaptability to a dynamic, changing environment.Preferred: Bachelor’s degree and medical device experience. Pay Range and Compensation Package:Salary range: $24.50—$37 USD per hour, commensurate with experience and qualifications. Benefits & Perks:Multiple health insurance plan options.Employer contributions to Health Savings Account.Dental, Vision, Life, and Disability benefits.401(k) plan with employer match.Identity Protection.Flexible time off.Tuition Reimbursement.Employee Assistance program.Employee equity awards and participation in Employee Stock Purchase Program. Equal Opportunity Statement: Our client is an equal opportunity employer. They celebrate diversity and are committed to creating an inclusive environment for all employees. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, or national origin. Note:TalentHop is a recruitment partner of this role. Please note that all employment decisions, including candidate assessment, interviews, hiring, compensation, and employment terms, are made exclusively by the hiring employer.