Senior Reimbursement Specialist - Order Entry Tuesday - Saturday 900 AM PST - 600 PM PST

As a Senior Reimbursement Specialist Order Entry you will play a key role in ensuring accurate and timely claims submission and reimbursement processing to support the financial health of Guardant Health. Leveraging your expertise in billing systems insurance guidelines and reimbursement strategies you will serve as a subject matter expert and mentor within the billing operations team. You will collaborate closely with internal teams including Finance Client Services and Laboratory Operations as well as with our billing platform provider to optimize order entry workflows and reimbursement outcomes.

In this seniorlevel role you will be responsible for managing complex claim issues resolving highimpact frontend rejections and contributing to the development and enhancement of processes and documentation. You will lead efforts in quality assurance and process improvement and may assist in onboarding and training of junior team members.

Key Responsibilities:

• Lead and execute the accurate entry of incoming demographics into the billing tool and ensure timely clean claims submissions using the HCFA 1500 form or electronic equivalent.
   
• Serve as a primary escalation point for complex or highpriority claims issues and frontend denials working directly with payer portals to troubleshoot and resolve issues efficiently.
   
• Perform comprehensive eligibility verification and coordination of benefits to ensure claims accuracy prior to submission.
   
• Maintain a high level of accuracy in data entry and account notations across multiple billing systems.
   
• Provide expertlevel reimbursement guidance and support to patients demonstrating empathy professionalism and superior customer service.
   
• Collaborate with crossfunctional teams to support initiatives related to payer engagement claim edits and process improvements.
   
• Ensure full compliance with HIPAA and all applicable regulatory standards; manage medical record requests for patients payers and providers as needed.
   
• Identify opportunities for operational efficiencies and contribute to the development and refinement of SOPs and best practices.
   
• Support training mentoring and knowledge sharing among junior team members.
   
• Participate in audits and other special projects as assigned.

Qualifications :

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• 36 years of recent experience in highvolume professional and/or facility billing and reimbursement with demonstrated expertise in order entry and claims submission processes.
   
• Proven ability to handle complex payer issues frontend rejections and escalated reimbursement inquiries with minimal oversight.
   
• Strong proficiency in billing platforms and payer portals; experience with laboratory billing systems such as Xifin is highly preferred.
• Strong experience with Salesforce or similar CRM.
   
• High level of comfort with Excel and Microsoft Office Suite; ability to analyze data and create process reports or summaries as needed.
   
• Strong knowledge of national and regional payer requirements and healthcare billing regulations.
   
• Excellent written and verbal communication skills with the ability to interact effectively with internal teams and external partners.
   
• Demonstrated ability to work both independently and collaboratively to meet deadlines and exceed performance targets.
   
• High school diploma or equivalent required; additional coursework or certifications in medical billing coding or revenue cycle operations a plus.
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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.

The US hourly range for this fulltime position is $24.15 to $33.22 The range does not include benefits and if applicable overtime bonus commission or equity. The range displayed reflects the minimum and maximum target for new hire salaries across all US locations for the posted role with the exception of any locations specifically referenced below (if any).

For positions based in Palo Alto CA or Redwood City CA the hourly range for this fulltime position is $28.41 to $39.08. 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.

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