Reimbursement Specialist II - Prior Authorization 900 AM - 530 PM CST Monday - Friday Shift
Reimbursement Specialist II - Prior Authorization 900 AM - 530 PM CST Monday - Friday Shift
Employer Active
Job Alert
You will be updated with latest job alerts via email
Share
Job Alert
You will be updated with latest job alerts via email
Not Disclosed
Salary Not Disclosed
1 Vacancy
Job Description
Location: Remote 3Days Hybrid and 5Days Onsite Options
Shift: 9:00 AM 5:30 PM CST Monday Friday Shift
As a Reimbursement Specialist II Prior Authorization you are a seasoned expert within the revenue cycle team driving impact through deep knowledge of insurance processes payer policy and prior authorization strategy. Based in Spring Texas you play a key role in ensuring patients receive timely access to care while maximizing reimbursement outcomes for the organization.
You will independently manage the full prior authorization lifecyclenavigating complex payer policies securing timely approvals and resolving escalated reimbursement issues. With your extensive background in healthcare billing and payer engagement you will lead efforts to streamline processes troubleshoot complex denials and collaborate with team members and ordering physician offices to ensure seamless communication. You will be responsible for managing documentation for appropriate payer communication handling correspondence and conducting insurance claim research. You will contribute to the development and implementation of training programs.
In collaboration with Finance Client Services Account Managers and our billing technology partners you will champion best practices and contribute to a highfunctioning compliant billing operation. Youll help build and maintain comprehensive documentation of payer requirements and support process improvement initiatives that increase efficiency and effectiveness across the department.
Qualifications :
- Minimum of 5 years of healthcare reimbursement experience with a strong focus on prior authorization insurance coordination and payer relations.
- Expertlevel knowledge of Medicare Medicaid and commercial payer authorization policies and appeals processes.
- Demonstrated success in managing complex highpriority claims including overturning denials through advanced appeal strategies and external reviews.
- Proficiency with revenue cycle tools and systems such as Xifin payer portals EDI enrollment and merchant/payment solutions.
- Advanced Excel capabilities including use of pivot tables conditional logic and trend analysis for reporting and decisionmaking.
- Proven track record of working crossfunctionally with internal teams and external stakeholders to resolve reimbursement challenges.
- Strong written and verbal communication skills with an ability to distill complex issues for both technical and nontechnical audiences.
- Detailoriented selfmotivated and driven to identify process improvements that enhance operational performance.
- Experience with laboratory billing workflows and national/regional payer requirements is highly desirable.
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 $22.39 to $30.80. 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 $26.34 to $36.22. 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
Company Industry
Key Skills
- Quality Analysis
- Facility
- ISO
- Inventory Levels
- Root cause Analysis
- Shift operations
- General Maintenance
- Daily Operations
- Supervision
- Analysis
- PLC
- Safety Standards
- Quality Standards
- Time management skills
- Troubleshooting
