Claims Analyst jobs in Plymouth, MA

We have unique opportunities 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. 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 Claims Analyst II is responsible for optimizing reimbursement for Organogenesis products, and services in which the products are used. This includes analyzing coding, claims, coverage and payment policies as needed for new/existing products.

Key Responsibilities

• Review and analyze all incoming claims
• Acts as a liaison between customers and insurance companies to resolve claims
• Track payer trends – coding requirements
• Provide reimbursement analysis including charges and payment rates by payer and provider
• Support Business Relationship Managers' field based issues
• Maintain reports and prepare reports related to the work
• Establish relationships with third party payers
• Respond to all incoming calls and emails related to claims
• Provide reviews to customers
• Other duties as assigned

Preferred Education and Experience

• BA/BS degree in Healthcare Administration, Business, Economics or related area
• Medical device or biologics experience
• 5 years' experience in the healthcare industry required
• Functional expertise in reimbursement and health care policy required
• An intimate knowledge of Claims, Medicare, Medicaid, Managed Care and Private Payor reimbursement process required

Other Skills/Abilities:

• Ability to be persistent while maintaining and developing a strong professional relationship with customers
• A proactive nature
• Excellent follow-through skills

Position can be Remote