Reimbursement Specialist - Follow Up & Appeals

Company Description

Guardant Health is a leading precision oncology company focused on helping conquer cancer globally through use of its proprietary tests, vast data sets and advanced analytics. The Guardant Health oncology platform leverages capabilities to drive commercial adoption, improve patient clinical outcomes and lower healthcare costs across all stages of the cancer care continuum. Guardant Health has commercially launched Guardant360®, Guardant360 CDx, Guardant360 TissueNext™, Guardant360 Response™, and GuardantOMNI® tests for advanced stage cancer patients, and Guardant Reveal™ for early-stage cancer patients. The Guardant Health screening portfolio, including the Shield™ test, aims to address the needs of individuals eligible for cancer screening.

Job Description

(We will consider this role for Hybrid (3 days), Remote & Onsite Options)

As a Reimbursement Specialist, Follow Up and Appeals, you play an important role in the overall success of the company. Working with our billing tool provider, you will drive payment for our services, and by partnering with colleagues in Finance and Client Services. You will facilitate optimized billing processes and operations that are aligned with Guardant Health’s mission and values.
You’re responsible for tracking, reporting and addressing complex outstanding claims. You will work to troubleshoot EOBs, appeal non-covered & low pay claims, follow-up on claims, and drive positive coverage determinations through external appeals. You will manage documentation for appropriate payer communication, correspondence, and insurance claim research.

Qualifications

High school diploma or equivalent

• Your background includes a minimum of 1 year of work experience in a healthcare environment focused on healthcare reimbursement, including knowledge of health plan regulations and processes. Your previous experience in similar roles enables you to hit the ground running and contribute insights and solutions to your team.
• You are interested in being on the ground floor of a dynamic, fast paced organization. You are organized and have strong attention to detail, are a self-starter and can work with minimal supervision. Tech savvy and analytical, you enjoy unpacking and resolving complex issues. Customer service is in your DNA, and you are known for your ability to communicate effectively through even the most tangled scenarios.
• You should have moderate Excel skills, like the ability to sort, filter and perform simple calculations. You have experience working with a broad range of payers and have appealed to state level agencies or external level review with IRO/IRBs.
• Employee may be required to lift routine office supplies up to 25 lbs and use office equipment. Majority of the work is performed in a desk/office environment; however, there may be exposure to high noise levels, fumes, and biohazard material in the laboratory environment. Ability to sit for extended periods of time.
• Familiarity with laboratory billing, Xifin, EDI enrollment, merchant solutions, payer portals and national as well as regional payers throughout the country are a plus.

Additional Information

For positions based in Palo Alto, CA or Redwood City, CA, the hourly range for this full-time position is $24.52 to $34.13. The range does not include benefits and, if applicable, overtime, bonus, commission, or equity.

Within the range, individual pay is determined by work location and additional factors, including, but not limited to, job-related skills, experience, and relevant education or training. If you are selected to move forward, the recruiting team will provide details specific to the factors above.

Employee may be required to lift routine office supplies and use office equipment. Majority of the work is performed in a desk/office environment; however, there may be exposure to high noise levels, fumes, and biohazard material in the laboratory environment. Ability to sit for extended periods of time.

Guardant Health is committed to providing reasonable accommodations in our hiring processes for candidates with disabilities, long-term conditions, mental health conditions, or sincerely held religious beliefs. If you need support, please reach out to [email protected]

Guardant Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, or protected veteran status and will not be discriminated against on the basis of disability.

All your information will be kept confidential according to EEO guidelines.
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Please visit our career page at: http://www.guardanthealth.com/jobs/