As a Reimbursement Specialist, 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.
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.
Your background includes three to five years 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 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.
Familiarity with laboratory billing, Xifin, EDI enrollment, merchant solutions, payer portals and national as well as regional payers throughout the country are a plus.
ABOUT THE TEAM
The Reimbursement Operations Team at Guardant Health is committed to building for the future, focusing on optimizing billing and reimbursement and ensuring we stay true to our company mission and values in the process.
Guardant Health develops breakthrough diagnostic technologies to improve cancer management. With Guardant360, we offer real-time, biopsy-free tumor sequencing that tracks tumor genomics in real-time and identifies associated treatment options. The recent introduction of groundbreaking analytical tools, including our Tumor Response Map and a mobile-enabled physician portal, further advance Guardant Health's momentum.
Guardant Health has raised almost $200M from OrbiMed, Sequoia Capital, Khosla Ventures, Lightspeed Venture Partners, and Formation8, and is led by a seasoned management team of thought leaders and successful serial entrepreneurs in next generation sequencing and rare cell diagnostics. They are advised by an oncologist-led medical steering committee from leading cancer centers.
Role: Reimbursement Specialist
Location: Redwood City,
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