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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
Coronary & Renal Denervation therapies are a vital component of the Medtronic Cardiovascular Portfolio. Our team is passionate about the patients we serve around the globe and the "second life" and improved health we can give to those with Coronary Artery Disease, High Blood Pressure, and other conditions.We're also driven by the promise of Renal Denervation and its potential to change the way patients around the world manage their uncontrolled hypertension.
The Senior Patient Access Support Coordinator V for 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 patient’s 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.
- Must Have; Minimum Requirements
- High School Diploma or equivalent
- Minimum of 10 years experience in case management, prior authorization or utilization review
- For a nurse, a current nursing licensure required.
- 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 & Power Point)
- 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.
Salary ranges for U.S (excl. PR) locations (USD):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).
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 90,000+ 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.
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.
At Medtronic, most positions are posted on our career site for 3-7 days.