Reimbursement Coordinator II

Medtronic • Full-time • Remote (United States) • $42.40k - $63.60k / year • 2d ago

We anticipate the application window for this opening will close on - 6 Jun 2026

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

A Day in the Life

Across our global Neuroscience organization, we advance care for some of medicine’s most complex neurological and spinal conditions. By combining innovative technology, data-driven insights, and deep clinical expertise, we partner with physicians and health systems to improve how patients are treated and supported throughout their care journey.

Our Neuromodulation Operating Unit provides advanced therapies for chronic pain, movement disorders, and other neurological conditions. Through spinal cord stimulation, deep brain stimulation, and targeted drug delivery systems, we deliver personalized treatments that restore function, reduce symptoms, and improve quality of life worldwide.

Check us out on LinkedIn: Medtronic Brain Modulation and Pain Interventions

The Prior Authorization Representative is responsible for verifying prior authorization requirements and obtaining authorization when required. Works directly with physician offices and payers to facilitate patient access to various therapies. The representative will ensure patient insurance coverage and benefits, identify requirements for prior approval, and submit for authorization. Assists with appealing prior authorization denials, retro authorization, or other special cases.

At Medtronic, we bring bold ideas forward with speed and decisiveness to put patients first in everything we do. This position is remote to enhance our competitive edge and expand cross-functional collaboration. This role will require some travel to enhance collaboration and ensure the successful completion of projects.

Responsibilities Include, But Are Not Limited To

Validates insurance patient’s coverage, communicates any issues with benefits or coverage to the appropriate managers
Checks the requirements for prior authorization and initiates as required
Coordinates required paperwork, clinical notes, and forms for submission to support requests and initiates as required
Follows up frequently to ensure visibility on authorization status throughout the approval process
Basic knowledge of the payer payment process, with detailed knowledge of the payer prior authorization process
Basic ICD9/10 and CPT code familiarity, expert knowledge on a subset of Medtronic therapy codes
Superior customer service skills with outstanding communication skills to use with various stakeholders: physicians, sales representatives, payer representatives, utilization reviewers, and various internal and external stakeholders.
Advanced Microsoft Excel skills. Ability to learn and use multiple CRM software programs as needed
Good organizational skills with the ability to handle multiple inquiries at the same time, and critical problem-solving skills with high attention to detail
Communicate with healthcare provider (HCP) office staff to clarify payer coverage requirements, confirm documentation needed for prior authorization submissions, and address questions related to medical policy criteria.
Monitor and interpret payer coverage policies and prior authorization requirements across Medicare, Medicaid, and commercial payers, serving as a subject matter resource on policy updates and coverage criteria that may impact authorization outcomes.
Develop and maintain working knowledge of reimbursement pathways, coding considerations, and payer coverage policies relevant to ENT devices in order to support accurate prior authorization submissions and resolve coverage-related inquiries.
Partner with field personnel to provide education, guidance, and ongoing support related to prior authorization processes, payer requirements, and reimbursement-related inquiries.
Support reporting activities by tracking prior authorization submissions, approval and denial trends, and payer policy changes to provide insights that inform reimbursement strategy and operational improvements.
Review prior authorization denials to identify root causes and conduct outreach to provider offices and payers to support reconsideration, resubmission, or appeal when appropriate.
Provide mentorship and training to new team members by sharing best practices, reimbursement knowledge, and guidance on prior authorization workflows and payer requirements.
Maintain and update prior authorization and reimbursement resources, including internal guidance documents, payer policy summaries, and process documentation to support team consistency and accuracy.
Support auditing and monitoring of program productivity by reviewing case activity, turnaround times, and authorization outcomes to help ensure operational effectiveness and process adherence.
Assist in addressing escalated prior authorization and reimbursement concerns by collaborating with internal teams, provider offices, and payers to facilitate resolution and support patient access.

Qualifications:

Must Have: Minimum Requirements

Minimum of 2 years of relevant experience

Nice to Have:

AAPC Coding Certificate
College Degree
Sales Force User
Customer Service Experience

For Baccalaureate degrees earned outside of the United States, a degree that satisfies the requirements of 8 C.F.R. § 214.2(h)(4)(iii)(A) is required.

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.

U.S. Work Authorization & Sponsorship

At Medtronic, we are committed to fostering an environment where employees can thrive and make a meaningful impact. In alignment with our enterprise-wide workforce planning approach, U.S. work authorization sponsorship (H-1B, TN, J, etc.) is offered exclusively for Principal-level roles and above, where specialized expertise aligns with long-term business needs. Roles below the Principal level require candidates to possess unrestricted U.S. work authorization at the time of hire and for the duration of employment.

Join us in our mission to alleviate pain, restore health, and extend life—where your unique background and perspective are valued.

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.

Salary ranges for U.S (excl. PR) locations (USD):$42,400.00 - $63,600.00
This position is eligible for a short-term incentive called the Medtronic Incentive Plan (MIP). The base salary range is applicable across the United States, excluding Puerto Rico and specific locations in California. The offered rate complies with federal and local regulations and may vary based on factors such as experience, certification/education, market conditions, and location. Compensation and benefits information pertains solely to candidates hired within the United States (local market compensation and benefits will apply for others).

The following benefits and additional compensation are available to those regular employees who work 20+ hours per week: Health, Dental and vision insurance , Health Savings Account , Healthcare Flexible Spending Account , Life insurance, Long-term disability leave , Dependent daycare spending account , Tuition assistance/reimbursement , and Simple 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 match , Short-term disability , Paid time off , Paid holidays , Employee Stock Purchase Plan , Employee Assistance Program , Non-qualified Retirement Plan Supplement (subject to IRS earning minimums) , and Capital 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 95,000+ 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 law. In addition, Medtronic will provide reasonable accommodations for qualified individuals with disabilities.

If you are applying to perform work for Medtronic, Inc. (“Medtronic”) in any position which will involve performing at least two (2) hours of work on average each week within the unincorporated areas of Los Angeles County, you can find here a list of all material job duties of the specific job position which Medtronic reasonably believes that criminal history may have a direct, adverse and negative relationship potentially resulting in the withdrawal of a conditional offer of employment. Medtronic will consider for employment qualified job applicants with arrest or conviction records in accordance with the Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act.