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Manager Prior Authorization Jobs in Minnesota (NOW HIRING)

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Overview The Prior Authorization Coordinator manages specific processes within the patient order. This position is responsible for checking status of authorizations/appeals with payers and contacting ...

Authorization Specialist

Saint Louis Park, MN · On-site

$19.25 - $25.75/hr

Park Nicollet is looking to hire an Authorization Specialist to join our Pain Management team! Come ... This position is responsible for completing insurance verification, obtaining and documenting prior ...

... Prior Authorization, Care Management, or Optum Clinical Manager is preferred. • AI tool proficiency is expected, including consistent use of enterprise-approved AI tools such as GitHub Copilot ...

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Manager Prior Authorization information

What is a Manager Prior Authorization job?

A Manager of Prior Authorization oversees the authorization process for medical treatments, ensuring that required approvals are obtained from insurance providers. They manage a team handling prior authorization requests, review policies to ensure compliance, and work to optimize efficiency in approval processes. This role involves collaboration with healthcare providers, insurance companies, and patients to minimize delays in care. Strong leadership, knowledge of insurance guidelines, and experience in healthcare administration are essential for success in this position.

What are some common challenges a Manager Prior Authorization might face, and how are they addressed?

A Manager Prior Authorization often encounters challenges such as managing high volumes of authorization requests, staying updated with changing insurance requirements, and ensuring quick turnaround times to avoid delays in patient care. Addressing these issues typically involves implementing efficient workflows, training staff on the latest policies, and leveraging technology to automate repetitive tasks. Collaboration with physicians, payers, and internal departments is also key to resolving complex authorization cases. Proactive communication and continuous process improvement help maintain compliance and streamline the overall prior authorization process.

What are the key skills and qualifications needed to thrive in the Manager Prior Authorization position, and why are they important?

To excel as a Manager Prior Authorization, you need expertise in healthcare administration, insurance processes, and prior authorization protocols, usually demonstrated by a bachelor's degree in healthcare or related fields and relevant experience. Familiarity with healthcare management software, electronic medical records (EMR), and insurance authorization systems is highly valuable, and certifications like Certified Prior Authorization Specialist (CPAS) can be advantageous. Outstanding leadership, attention to detail, and effective communication are pivotal for managing teams and streamlining workflows. These skills and qualities ensure compliance, reduce delays in patient care, and improve overall operational efficiency within healthcare organizations.

What are the most commonly searched types of Prior Authorization jobs in Minnesota? The most popular types of Prior Authorization jobs in Minnesota are:
What are popular job titles related to Manager Prior Authorization jobs in Minnesota? For Manager Prior Authorization jobs in Minnesota, the most frequently searched job titles are:
What job categories do people searching Manager Prior Authorization jobs in Minnesota look for? The top searched job categories for Manager Prior Authorization jobs in Minnesota are:
Infographic showing various Manager Prior Authorization job openings in Minnesota as of July 2026, with employment types broken down into 87% Full Time, 3% Part Time, 1% Temporary, 5% Contract, and 4% Nights. Highlights an 97% In-person, and 3% Hybrid job distribution.

Prior Authorization Specialist

Inspire Medical Systems Inc.

Minneapolis, MN • Remote

$18.75 - $25/hr

Other

Posted 26 days ago


Job description

*Fully Remote Position*

ABOUT THIS POSITION  

We are recruiting for a Prior Authorization Specialist to join our team. In this role, you will be providing expertise in the area of prior authorization and will be responsible for implementing the Inspire Prior Authorization Program in the United States. You will be working with the Territory Managers and the prior authorization team to ensure all coding and coverage questions are answered correctly and concisely.

OPPORTUNITIES YOU WILL HAVE IN THIS ROLE  

  • Support Inspire's Prior Authorization Program, including:
    • Entering and managing patient information in database
    • Assisting with patient intake and verifying of insurance coverage
    • Calling insurances to obtain the status of Prior authorization requests
    • Working with patients and sites to pursue authorization success.
  • Assist in tracking and monitoring progress of prior authorization requests, along with all related appeals through to EMR.
  • Participate in updating the packet of materials and best practices methods to support the prior authorization and appeals processes, including External Medical Review, (EMR) for upper airway stimulation.
  • Seek continuous process improvement to increase success rates and reduce time to success.
  • Implement Inspire's Prior Authorization Program, including:
    • Training sites on program requirements
    • Entering and managing patient information in database
    • Completing prior authorization requests
    • Providing guidance to participating sites on all levels of appeals including EMR
    • Working directly with the patient to pursue EMR success.
  • Provide general coding information to physician customers upon request.
  • Work in conjunction with manager and staff to execute action plans and objectives to support internal/external clients.

QUALITY SYSTEM RESPONSIBILITIES

  • Document product and therapy related field reports within the prescribed timelines and provide any necessary documents required to complete the investigation. Provide follow-up reporting as needed.
  • Complete training requirements and competency confirmations as required for this position within the required timeline.
  • Comply with applicable quality system procedures/policies and make suggestions for continuous process improvement.

WHAT YOU CAN BRING TO OUR GREAT TEAM

Required: 

  • 2+ years of related work experience in reimbursement
  • Demonstrated knowledge of reimbursement compliance requirements and a maintaining a high level of personal integrity to promote a compliant reimbursement environment
  • Ability to read, interpret and appropriately respond to payer requirements relating to prior authorization
  • Ability to read, interpret and summarize clinical and cost literature
  • Excellent written and oral communication skills
  • Proficient in Microsoft Office applications, including Word, PowerPoint, Excel
  • High attention to detail and strong team attitude
  • Comfortable in a small, dynamic company environment with frequent changes in direction

Preferred: 

  • Bachelor's degree
  • Medical device experience

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