Provider Benefit Verification Specialist II

Organogenesis, Inc.•Canton, MA

46d•$60,000 - $70,000•Hybrid

About The Position

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 mission is to advance healing and recovery beyond expectations. 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. Training will be on-site. After training is completed, this position requires one day per week in office. The hours for this position are 9:00amEST to 5:30pmEST.

Requirements

High school diploma or equivalent required. BA/BS degree in Healthcare Administration, Business, Economics preferred.
3+ years' experience working in Healthcare reimbursement required.
1+ year of Prior Authorization experience required.
Functional expertise in reimbursement and healthcare policy, with strong knowledge of Medicare, Medicaid, managed care and private payer reimbursement process required.
Ability to communicate in a professional manner with providers, insurances, and internal customers and colleagues required.

Nice To Haves

Medical device or biologics experience preferred.
Polished and professional presence and phone manner.
Excellent customer service skills.

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.

Benefits

401k -- generous employer match with immediate vesting and financial planning resources
Comprehensive Medical, Dental and Vision coverage options effective on day one of employment
Flexible Spending Account (medical expenses or dependent care expenses) or Health Savings Account
Company paid insurances including Short Term, Long Term and Life insurances as well as voluntary options
Paid maternity leave and parental leave for all new parents
Adoption benefits
Education Assistance Policy - up to $5,000 per year for all employees
Wellness Program including free trainings on mental health, mindfulness, stress reduction, on-site flu shots and more
Employee Assistance Program
Generous paid time off including vacation, floating holidays, sick days, and company holidays
Free parking including an electric charging station (Canton and La Jolla)
Discounts at BJs Wholesale, Dell, Sullivan Tire, and Sprint