What are the responsibilities and job description for the Provider Benefit Verification Specialist III position at Organogenesis?
About Us
We are a leading regenerative medicine company in the advanced and acute wound care space and are always looking for exceptional talent. Join a company where you will have an opportunity to grow professionally and personally and give strength to others by Empowering Healing. Our advanced wound care products are specially developed for the successful treatment of chronic and acute wounds. Our comprehensive portfolio of skin substitutes and other regenerative medicine products empower our patients with life-changing solutions. Our strength is giving others strength.
Learn more about Careers at Organogenesis
What You Will Achieve: The Provider Benefit Verification Specialist III is part of the Reimbursement team and assists with the reimbursement process.. This position helps with patient assistance programs, coverage verification, information on ordering and shipping, and details on coding. From the moment our products are deemed appropriate for patients, through treatment, we're with the customer every step of the way. The hours for this position are Monday - Friday from 9amEST - 5:30pmEST or 9:30amEST - 6pmEST. Training will be on-site (two to three months) with a hybrid work schedule after training is complete (in office one day a week.) The ideal candidate will be located in Canton, MA or nearby. This position reports to the Supervisor of Reimbursement.
How You Will Achieve It:
- 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
- Complete 16-22 Reimbursement cases, 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
