Reimbursement & Benefits Representative

Medical Device Manufacturer is expanding their services to support Penile Implant surgeries. This team will handle the additional workload to assist customers in securing insurance coverage for their procedures. Launched just a year ago, the program has already seen more than double the volume and expects continued growth. The role involves verifying benefits and managing prior authorizations, working directly with physician offices to ensure coverage for surgeries.

Responsibilities

• Act as an advocate for customers regarding insurance coverage.
• Contact insurance carriers to obtain benefit coverage, policy limitations, authorization/notification, and pre-certifications.
• Secure authorizations or pre-certifications required for patients to access coverage for Interventional Urology products.
• Demonstrate knowledge of commercial payers, Medicare, and Medicaid, including their benefit structures.
• Request medical documentation from providers (e.g., nurse case reviewers, clinical staff) to support claims for medical necessity.
• Educate customers, staff, and providers on referral and authorization requirements, payer coverage, eligibility guidelines, documentation requirements, and insurance-related changes or trends.
• Verify that all products requiring prior authorizations are complete and update customers and the customer support team on status.
• Assist in coordinating appeals if required by insurance payers.
• Maintain up-to-date knowledge of Medicare, Medicaid, and commercial payer requirements, guidelines, and policies.
• Communicate reimbursement and access topics clearly and concisely to office staff and/or patients.
• Work with customers when exceptions to coverage are needed.
• Answer incoming calls from customers/patients about the insurance verification process using professional, knowledgeable, and courteous customer service skills.
• Investigate and resolve anomalies in insurance information, using critical thinking to ask additional questions and find solutions when insurers cannot provide clear answers.
• Perform other duties as assigned by the management team.

Skills

• Benefits management
• Benefits enrollment
• Reimbursement
• Insurance verification
• Customer service support
• Claims resolution
• Appeals
• Claims adjudication

Requirements

• High School Diploma.
• 3+ years of experience with medical insurance verification.
• Knowledge of insurance benefit verification requirements, guidelines, and policies.
• Familiarity with insurance plans requiring pre-authorization.
• Experience in a healthcare-related industry.

Pay

The pay range for this position is $23.00 - $25.00 per hour. Individual compensation within this range will depend on qualifications, skills, relevant experience, job knowledge, geographic location, internal equity, and other job-related factors.

Benefits

Eligibility requirements apply to some benefits and may depend on job classification and length of employment. Benefits are subject to change and may include specific elections, plan, or program terms. If eligible, benefits for this temporary role may include:

• Medical, dental, and vision insurance.
• Critical Illness, Accident, and Hospital insurance.
• 401(k) Retirement Plan – Pre-tax and Roth post-tax contributions available.
• Life Insurance (Voluntary Life & AD&D for the employee and dependents).
• Short- and long-term disability.
• Health Spending Account (HSA).
• Transportation benefits.
• Employee Assistance Program.
• Time Off/Leave (PTO, Vacation, or Sick Leave).

Schedule

This is a hybrid position based in Minneapolis, MN. The role is a contract position with an anticipated closing date of August 31, 2026.