Reimbursement Specialist II - Follow Up & Appeals - Screening
Reimbursement Specialist II - Follow Up & Appeals - Screening
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1 Vacancy
Job Description
About the Role:
As a Reimbursement Specialist II Follow-Up and Appeals you will be a vital contributor to our companys success by ensuring accurate and timely reimbursement for our services. Collaborating closely with our billing technology provider Finance and Client Services teams you will help optimize billing processes enhance operational efficiency and uphold Guardant Healths commitment to excellence and integrity.
Essential Duties and Responsibilities:
- Monitor and manage complex outstanding insurance claims ensuring timely follow-up and resolution
- Troubleshoot Explanation of Benefits (EOBs) and identify reasons for claim denials or low payments
- Prepare and submit appeals for non-covered services low payments or disputed claims aiming to secure positive coverage determinations through external appeals
- Maintain detailed documentation of payer communications claim statuses and research activities
- Collaborate with internal teams and external payers to resolve billing issues and improve reimbursement outcomes
Qualifications :
- 3 years of experience in healthcare reimbursement with a solid understanding of health plan regulations payer policies and claims processing
- Basic proficiency in Excel (sorting filtering simple formulas)
- A proactive organized self-starter with a keen eye for detail and a passion for problem-solving in a fast-paced environment
- Strong communication skills with the ability to navigate complex scenarios and maintain professional relationships with payers and colleagues
- Proven ability to work independently prioritize tasks and manage multiple claims efficiently
- Experience working with diverse payers including state agencies IRO/IRB reviews and external review processes
- Familiarity with laboratory billing systems Xifin EDI enrollment payer portals and regional/national payers is a plus
Additional Information :
Hybrid Work Model: At Guardant Health we have defined days for in-person/onsite collaboration and work-from-home days for individual-focused 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 in-office 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 work-life balance while keeping teams connected to advance our science for our patients.
The US hourly range for this full-time 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).
Within the range individual pay is determined by work location and additional factors including but not limited to job-related 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 long-term 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 :
Full-time
Employment Type
Remote
