Provider Benefit Verification Specialist

Canton, MA

Job Req code: 669

Category: Customer Service

Organogenesis, a leader in regenerative medicine located in Canton, is seeking Provider Benefit Verification Specialists to join our growing company. This team of specialists provides billing and reimbursement support to sales specialists and customers.

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 insure 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.
Other duties as needed.


Associate's degree preferred. Equivalent experience will be accepted in lieu of degree.
3+ years of work experience in the healthcare industry preferred.
Functional expertise in reimbursement and healthcare policy, with strong knowledge of Medicare, Medicaid, managed care and private payer reimbursement process required.
Polished and professional presence and phone manner, and excellent customer service skills required.