- 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.
- Polished and professional presence and phone manner.
- Excellent customer service skills.
- 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.
- Remaining in a sitting position for long periods of time.
- Repeating motions that may include the wrists, hands, and/or fingers.
- Working indoors
- No adverse environmental conditions
- 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 - $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
-
Provider Benefit Verification Specialist II
1 week ago
Organogenesis St Petersburg, United StatesJob Description: · 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 ot ...
-
Provider Benefit Verification Specialist II
2 weeks ago
Organogenesis Saint Petersburg, FL, United StatesWe are a leading regenerative medicine company in the advanced and acute wound care space and are always looking for exceptional talent. Petersburg, FL office is looking for a dynamic and detailed oriented Provider Benefit Verification Specialist II to join the team In this posit ...
-
Organogenesis Saint Petersburg, United States**Job Description**: · **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 ...
-
Medical Billing Specialist 1 or 2
4 weeks ago
Pinellas County FL Clearwater, United StatesMedical Billing Specialist - 1 or 2 · Location: Ulmerton Rd., Largo, FL · Schedule: Monday - Friday, 8am to 5 pm · Come work in a fast-paced high-energy office, utilizing your medical billing expertise. Pinellas County Ambulance Billing is one of the largest ambulance provider ...
-
Medical Director
3 weeks ago
ACI Federal Petersburg, United States Part timeTitle Medical Director · EOE Statement We are an equal employment opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status or any other ...
-
Patient Service Specialist
6 days ago
Select Medical St Petersburg, United StatesWhen patients enter our center in St. Petersburg, we want them to have an exceptional experience – starting at the front desk. That's where you come in. As a patient service specialist, you'll manage both the patient side and business side of our center. The front desk is your st ...
-
Patient Service Specialist
4 days ago
Select Physical Therapy Clearwater, United StatesOverview · When patients enter our center in Clearwater, we want them to have an exceptional experience – starting at the front desk. That's where you come in. As a patient service specialist, you'll manage both the patient side and business side of our center. The front desk is ...
-
Customer Support Specialist
1 week ago
SureCost Saint Petersburg, United StatesJob Description · Job DescriptionCustomer Support Specialist Title: Customer Support Specialist · Type: Full-time (Exempt) · Location: Fully Remote (United States) · Reports to: Director of Customer Success · Who We Are: · SureCost is the leading provider of pharmacy purchasing a ...
-
HR Specialist-Compliance
1 week ago
Empath Health Clearwater, United StatesEmpath Health is currently seeking an Human Resources Specialist - Compliance to join our team. · This position provides high level administrative support to the HR Compliance and Operations Manager with a focus on HR Compliance. It also provides administrative support to the Hu ...
-
HR Specialist-Compliance
1 week ago
Empath Health Clearwater, United StatesEmpath Health is currently seeking an Human Resources Specialist - Compliance to join our team. · This position provides high level administrative support to the HR Compliance and Operations Manager with a focus on HR Compliance. It also provides administrative support to the Hu ...
-
A Youth Development Specialist
3 weeks ago
YMCA of the Suncoast Clearwater, United StatesLocation: · YMCA of the Suncoast · Pinellas/Pasco School Age Programs · Rate of pay: $14.50/hr. - $15.00/hr. · Shift: Monday - Friday program is open 6:00 am to 6:00 pm, shift varies with in program hours · JOB SUMMARY: · The Youth Development Specialist is responsible for ...
-
YREADS Youth Development Specialist
1 week ago
YMCA of the Suncoast Clearwater, United StatesLocation: · YMCA of the SuncoastPinellas/Pasco School Age ProgramsFrontier Elementary · Rate of pay: $14.50/hr. - $15.00/hr. · Shift: Monday - Friday program is open 6:00 am to 6:00 pm, shift varies with in program hours · Addendum for YREADS Program: · *1. Assume responsibi ...
-
PoolCorp Clearwater, United StatesCompany Overview · POOLCORP is the leading business-to-business distributor of swimming pool and landscape supplies, equipment, and related outdoor living products. Through our subsidiaries, SCP Distributors LLC, Superior Pool Products LLC, and Horizon Distributors Inc., we oper ...
-
Client Executive, Florida
1 week ago
BlueVoyant St Petersburg, United StatesClient Executive, Florida · Location: Florida: Preferably South Florida or Tampa/St Pete Florida · Are you passionate about helping to solve the critical cybersecurity challenges that enterprises are facing today? Are you passionate about building your business and disrupting you ...
-
child protective investigator
2 weeks ago
My Florida Corp Defunct St Petersburg, United StatesCHILD PROTECTIVE INVESTIGATOR · Date: May 24, 2024 · Location: · ST PETERSBURG, FL, US, 33701 · The State Personnel System is an E-Verify employer. For more information click on our E-Verify Website ) . · Requisition No: 828209 · Agency: Children and Families · Working Title: CH ...
-
Accounts Payable Specialist
3 weeks ago
Creative Financial Staffing St Petersburg, United StatesAccounts Payable Specialist · Unlock Your Potential as an Accounts Payable Specialist in the Construction Industry · Join a Thriving Finance Team at a Premier Construction Organization · Are you a dedicated professional with an eye for detail and a love for numbers? Our client, a ...
-
Accounts Payable Specialist
2 weeks ago
Creative Financial Staffing St Petersburg, United StatesAccounts Payable Specialist · Unlock Your Potential as an Accounts Payable Specialist in the Construction Industry · Join a Thriving Finance Team at a Premier Construction Organization · Are you a dedicated professional with an eye for detail and a love for numbers? Our client ...
-
Staff Insurance Specialist
2 weeks ago
KG Health Partners Clearwater, FL, United States Full timeOverview: · Insurance Verification Specialist · Summary: The Insurance Verification Specialist requires specific knowledge of health insurance plans, interpretation of benefits, and prior authorization protocol. Also, general knowledge of data management, medical practice workf ...
-
Account Services Specialist
3 weeks ago
Bank OZK St Petersburg, United StatesAccount Services Specialist · Job ID: 14170 · Functional Area: Retail/Community Banking · Position Type: Full-Time Regular · Experience Required: 1 - 3 Years · Location: St Petersburg, FL 4th St · Department: Association Services · Education Required: High School Diploma or ...
-
SUPERVISORY AUDITOR
4 weeks ago
Defense Contract Audit Agency St Petersburg, United StatesSummary · DCAA is ranked in the top third of the "Best Places to Work in the Federal Government." · This job is open to The public · U.S. Citizens, Nationals or those who owe allegiance to the U.S. · Clarification from the agency · All US Citizens. · DutiesServes as the Sup ...
Provider Benefit Verification Specialist II - St. Petersburg, United States - Organogenesis Inc
Description
Provider Benefit Verification Specialist II
th Street North, St. Petersburg, Florida, 33716, United States
Job Req code 405
Category: Reimbursement
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 St. Petersburg, FL 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.
How You Will Achieve It:
Other Skills/Abilities
Requirements
What You Need to Achieve It:
Physical Activities
Environmental Conditions
What can we offer you:
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, genetic information or any other characteristic protected by law.
