Guardant Health
Reimbursement Specialist - Follow Up & Appeals
Guardant Health, Palo Alto, California, United States, 94306
Reimbursement Specialist - Follow Up & Appeals
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.(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.Minimum Requirements: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 a 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. The 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.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.
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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.(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.Minimum Requirements: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 a 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. The 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.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.
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