Supervisor Reimbursement - Follow Up Appeals - Screening Monday - Friday

Monday through Friday Shift

As a Supervisor Reimbursement Follow Up & Appeals for the Screening Team you play an important role in the overall success of the company and oversight to a dedicated team of Individual Contributors. This role is pivotal in driving sustainable improvements in Average Sale Price (ASP) and overall revenue cycle performance by leading mentoring and optimizing processes within the Department. The role requires a collaborative proficient in data analysis process optimization and crossfunctional coordination committed to maintaining high standards in claim adjudication and fostering a culture of continuous quality enhancement.

You will facilitate optimized billing processes and operations that are aligned with Guardant Healths mission and values. You are responsible for facilitating efficiency improvements such as: Claims and Appeal Followup EDI/ERA/EFT enrollments lockbox improvements eligibility validations and provider payer portal registration properly and timely. This includes managing daytoday activities and provides guidance to the team to ensure accurate and timely documentation for services related to the members claim and/or appeal. You will be expected to be knowledgeable of and be able to perform the duties of the staff supervised. Strong communication and troubleshooting skills are required.

Essential Duties and Responsibilities:

• Serve as the knowledge expert and information source for staff key stake holders compliance processes regulations or compliance issues.
• Assist Revenue Cycle Manager Leadership with proactively auditing claims and collections in accordance with all thirdparty contract terms including Medicare managed care commercial insurance and direct patient pay.
• Assure maximization of cash collections through organized diligent and timely focused monitoring of all open accounts receivable balances.
• Analyze reimbursement from all sources including carrier reimbursement exception reporting and follow up pending claims analysis and denials management. Presents findings to leadership and develop action plans to mitigate risks.
• Prepare detailed analyses and reports of billing and accounts receivable activity and results including performance matrixes bad debt expense and AR days outstanding.
• Coordinate and participate in the audits of billing records to ensure accurate and complete data has been submitted for billing along with payment receipt and subsequent posting of monies contractual adjustments etc...
• Assists in the development of department Standard Operating Procedures (SOPs) according to the Clinical Laboratory Standards Institute (CLSI) guidelines.
• Maintain and enhance billing policies and procedures for each function in the revenue cycle process and ensure staff adherence to policies procedures and due dates.
• Evaluates team key performance indicators (KPIs) and provides feedback regarding performance development goals and career competencies.
• Provides coaching and guidance to individual contributors to ensure accurate and timely documentation for services and improve processing and quality of clean claims and appeal submissions. Ensuring billing is submitted for payment within preestablished deadlines.
• Assists with onboarding hiring and training individual contributors. Participates in developing and/or updating job aids training modules workflows and implements change management strategies
• Manage the import and export of documents through insurance portals ensuring timely submission of reconsideration/appeals requests ensuring accuracy and compliance with procedures
• Follow appropriate HIPAA guidelines
• Work well individually and in a team environment accomplishing set KPI goals
• Performs other related duties as assigned to support the overall efficiency of the department

Travel Requirements:

This role may require some travel that may include but is not limited to:

• Participating in corporate events and quarterly/biannually/annually meetings to connect with fellow leaders and share innovative strategies.
• Engaging in leadership development opportunities and conferences that will enhance your skills and knowledge empowering you to lead your team effectively.
• Initiating and participating in teambuilding activities in person with your direct reports and collaborating with crossfunctional teams to foster a strong united workplace culture.

Qualifications :

• High school diploma or equivalent degree from an accredited college or university in business healthcare administration or related major (relevant experience may be considered in lieu of degree)
• A minimum of 3years of recent experience in both professional healthcare revenue cycle management and at least 1 year of related experience in a leadership role reflective of the level of this position
• Excellent leadership and team management skills
• Exceptional attention to detail and accuracy
• Knowledge of medical terminology CPT and ICD coding
• Knowledge in managed care requirements as they relate to reimbursement knowledge of US Commercial Medicare Medicaid and thirdparty payer reimbursement preferred
• Experience with contacting and follow up with insurance carriers file reconsideration requests formal appeals and negotiations (preferred)
• Must be proficient using a computer PC software specifically Microsoft Office Suite particularly Excel and have above average typing skills
• Excellent communication skills both written and verbal
• Familiarity with laboratory billing Xifin Telcor payer portals and national as well as regional payers throughout the country are a plus
• Ability to effectively incorporate the mission and core values into processes and workflows
• Effective interpersonal skills to facilitate work in a team environment and to collaborate with a variety of professionals
• Strong decision making and selfmotivation skills
• Strong problemsolving skills and ability to troubleshoot issues effectively

Work Environment

Majority of the work is performed in a desk/office environment. Ability to sit/stand for extended periods of time.

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 base salary range for this fulltime position is $83220 to $114450. The range does not include benefits and if applicable 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).

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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