Reimbursement Specialist - Prior Authorization 900 AM - 530 PM CST Monday - Friday Shift
Reimbursement Specialist - Prior Authorization 900 AM - 530 PM CST Monday - Friday Shift
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Job Description
Job Description
Location: Remote 3Days Hybrid and 5Days Onsite Options
Shift: 9:00 AM 5:30 PM CST Monday Friday Shift
As a Reimbursement and Prior Authorization Specialist located in Spring Texas you play an important role in the overall success of the company. Working with our billing tool provider and partnering with colleagues in Finance and Client Services you will drive payment by contacting insurance companies to secure preauthorization required for patients to receive our services. You will ensure information obtained is complete and accurate follow up on requests and apply acquired knowledge of Medicare Medicaid and other ThirdParty Payer requirements and online eligibility/preauthorization systems. You will facilitate optimized billing processes and operations that are aligned with Guardant Healths mission and values.
You will help develop and maintain a database of payer authorization requirements and manage documentation for appropriate payer communication correspondence and insurance claim research. Youre responsible for tracking reporting and addressing complex outstanding claims. You will work to troubleshoot EOBs appeal noncovered and inappropriately adjudicated claims followup on claims and drive positive coverage determinations through external appeals.
Qualifications :
You are interested in being on the ground floor of a dynamic fastpaced organization. You are organized have strong attention to detail and are a selfstarter who can work with minimal supervision. Techsavvy 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 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 experience coordinating with insurance providers physicians and patients to obtain prior authorizations. You have also 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.
Additional Information :
Hybrid Work Model: At Guardant Health we have defined days for inperson/onsite collaboration and workfromhome days for individualfocused time. All U.S. employees who live within 50 miles of a Guardant facility will be required to be onsite on Mondays Tuesdays and Thursdays. We have found aligning our scheduled inoffice days allows our teams to do the best work and creates the focused thinking time our innovative work requires. At Guardant our work model has created flexibility for better worklife balance while keeping teams connected to advance our science for our patients.
For positions based in Palo Alto CA or Redwood City CA the hourly range for this fulltime position is $24.15 to $36.25 USD. 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 jobrelated 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 longterm conditions mental health conditions or sincerely held religious beliefs. If you need support please reach out to
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.
To learn more about the information collected when you apply for a position at Guardant Health Inc. and how it is used please review our Privacy Notice for Job Applicants.
Please visit our career page at: Work :
Yes
Employment Type :
Fulltime
Employment Type
Remote
