What are the responsibilities and job description for the Provider Benefit Verification Specialist II position at Organogenesis?
We have unique opportunities and are always looking for exceptional talent. Join the leader in regenerative medicine where you will have an opportunity to grow professionally and personally and give strength to others by Empowering Healing. We offer a strong benefits package, opportunities for growth, and the chance to contribute to our mission: to provide an integrated portfolio of healing solutions that improve lives while lowering the overall cost of health care.
The Canton, MA office is looking for a dynamic and detailed oriented Provider Benefit Verification Specialist II to join the team! In this position, the Provider Benefit Verification Specialist will provide billing and reimbursement support to sales specialist and customers. This position reports to the Manager of Reimbursement and is a hybrid position with one to two days in office every week. Hours are
Key Responsibilities
- Investigate patient’s medical benefits and identify opportunities for prior authorizations.
- Prepare and submit prior authorizations in a timely manner.
- Effectively interface with hospitals, wound care centers and physicians to ensure the highest level of reimbursement is attained.
- Communicate and accurately document payer trends.
- Foster partnerships with national accounts.
- Monitor and update Medicare, Medicaid and private payer policies and guidelines.
- Monitor and communicate policy developments that impact the reimbursement success of products.
- Help build relationships in key markets with government, physician, hospital, and third-party payer decision makers.
- Demonstrate a strong understanding of payer policies and how to leverage this knowledge to support the benefit verification process
- Understand and utilize reimbursement tools to minimize customer inquiries.
- Ability to meet strict metrics for quota and turn-around time
- 16-22 Reimbursement cases completed consistently
- Comply with all company policies and procedures
- Other duties as needed.
Other Skills/Abilities
- Polished and professional presence and phone manner.
- Excellent customer service skills.
Preferred Education And Experience
- High school diploma or equivalent required. BA/BS degree in Healthcare Administration, Business, Economics preferred.
- 3 years’ experience working in Healthcare reimbursement required.
- Functional expertise in reimbursement and healthcare policy, with strong knowledge of Medicare, Medicaid, managed care and private payer reimbursement process required.
- Medical device or biologics experience preferred.
- Ability to communicate in a professional manner with providers, insurances, and internal customers and colleagues required.
Physical Activities
- Remaining in a sitting position for long periods of time.
- Repeating motions that may include the wrists, hands, and/or fingers.
Environmental Conditions
- Working indoors
- No adverse environmental conditions
What we offer:
- Competitive Pay
- Comprehensive Medical, Dental and Vision coverage options
- 401K – vested immediately with 100% match
- Education Assistance Policy - $5,000 per year for all employees
- Company paid Short Term and Long Term disability
- Flexible Spending Account or Health Savings Account
- Wellness Program
- Three weeks of vacation, floating holidays, sick days, and company holidays
- Discounts at BJs Wholesale, Dell, Sullivan Tire, and Sprint
We are an equal opportunity/affirmative action employer. All qualified applicants will receive consideration for employment without regard to age, sex, gender identity, sexual orientation, race, color, religion, national origin, disability, protected veteran status, or any other characteristic protected by law.
Salary : $5,000
