Reimbursement Specialist II - Screening (9:00 AM - 6:00 PM PST, Monday - Friday Shift)

$57,013 - $91,208/Yr

Guardant Health

Full-time

Remote

Ambulatory Health Care Services

About the position

The Reimbursement Specialist II at Guardant Health plays a crucial role in optimizing billing and reimbursement processes within the healthcare environment. This position involves collaborating with various teams to ensure efficient payment for services, addressing complex claims, and driving positive coverage determinations. The role is integral to the company's mission of improving patient outcomes and lowering healthcare costs through advanced oncology solutions.

Responsibilities

• Drive payment for services by collaborating with billing tool providers and internal teams.
• Track, report, and address complex outstanding claims.
• Troubleshoot Explanation of Benefits (EOBs) and appeal non-covered and low pay claims.
• Follow up on claims and drive positive coverage determinations through external appeals.
• Manage documentation for payer communication and insurance claim research.

Requirements

• 3-5 years of work experience in a healthcare environment focused on healthcare reimbursement.
• Knowledge of health plan regulations and processes.
• Moderate Excel skills, including sorting, filtering, and performing simple calculations.
• Experience working with a broad range of payers and appealing to state level agencies or external review bodies.
• Experience using Telcor is required.

Nice-to-haves

• Familiarity with laboratory billing, Xifin, EDI enrollment, and merchant solutions.
• Experience with payer portals and national as well as regional payers.

Benefits

• Flexible work model with defined in-office and remote work days.
• Competitive hourly wage range based on location and experience.