Reimbursement Specialist II - Follow Up & Appeals
Reimbursement Specialist II - Follow Up & Appeals
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1 Vacancy
Job Description
(This position is Full-Time; will consider Full-Time Remote 3-Days Hybrid and 5-Days Onsite Options Shift: Monday - Friday 8:00 AM - 5:00 PM PST)
As a Reimbursement Specialist II Follow Up & Appeals you will play a vital role in ensuring the financial success of our organization. Collaborating with our billing tool provider finance and client services teams you will streamline billing operations optimize reimbursement processes and support the companys mission and values.
Essential Duties and Responsibilities:
- Track report and resolve complex outstanding claims.
- Troubleshoot Explanation of Benefits (EOBs) and identify reasons for claim denials or low payments.
- Appeal non-covered or underpaid claims through external review channels.
- Follow up on unpaid claims to ensure timely resolution.
- Drive positive coverage determinations through external appeals.
- Maintain accurate documentation of payer communications correspondence and insurance research.
Qualifications :
- 0-2 years experience in a healthcare reimbursement role
- Solid understanding of health plan regulations billing processes and payer interactions.
- Experience with appeals at state and external review levels (IRO/IRBs) is preferred.
- Organized with strong attention to detail
- Self-starter capable of working independently with minimal supervision
- Tech-savvy and analytical able to troubleshoot complex issues
- Excellent written and verbal communication skills especially in challenging scenarios
- Moderate proficiency in Excel (sorting filtering basic calculations)
- Familiarity with laboratory billing Xifin EDI enrollment payer portals merchant solutions and national/regional 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 $22.39 to $30.79. 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 full-time position is $26.35 to $36.23. 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 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
Company Industry
Key Skills
- Sales Experience
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- OSHA
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