Medical Reimbursement Specialist

4 days ago


Palo Alto, California, United States Guardant Health Full time

Guardant Health is a leading precision oncology company dedicated to helping conquer cancer globally. The organization focuses on leveraging its proprietary tests, vast data sets, and advanced analytics to drive commercial adoption, improve patient clinical outcomes, and lower healthcare costs across the cancer care continuum.

Job Overview

This role is part of the Reimbursement Operations - Screening Team at Guardant Health, committed to building for the future by optimizing billing and reimbursement processes. As a Reimbursement Specialist II, you will play a crucial role in the company's overall success by driving payment for services, partnering with colleagues in Finance and Client Services, and facilitating optimized billing processes aligned with Guardant Health's mission and values.

Key Responsibilities
  1. Track, report, and address complex outstanding claims
  2. Troubleshoot EOBs, appeal non-covered & low pay claims, follow-up on claims, and drive positive coverage determinations through external appeals
  3. Manage documentation for appropriate payer communication, correspondence, and insurance claim research
Requirements
  • Three to five years of work experience in a healthcare environment focused on healthcare reimbursement, including knowledge of health plan regulations and processes
  • Moderate Excel skills, such as sorting, filtering, and performing simple calculations
  • Experience working with a broad range of payers and appealing to state level agencies or external level review with IRO/IRBs
Estimated Salary

The estimated salary for this position is between $27.41 and $43.85 per hour, based on the location and requirements of the role. This figure does not include benefits, overtime, bonus, commission, or equity.



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