Manager, Reimbursement Operations

12 hours ago


Brisbane, California, United States CareDx, Inc. Full time
Job Summary

CareDx, Inc. is a leading precision medicine solutions company focused on the discovery, development, and commercialization of clinically differentiated, high-value healthcare solutions for transplant patients and caregivers. We are seeking a highly skilled Reimbursement Manager to join our team and assist in resolving revenue cycle problems. The successful candidate will supervise and oversee staff in duties pertaining to patient billing, communications with health insurance, collections, cash posting, account management, and contract analysis.

Key Responsibilities:

  • Strong knowledge of vendor relations, including Frontrunner, Glidian, and Careviso (Cover My Test)
  • Strong knowledge of billing software, including Telcor, Quadax, Waystar, and Xifin
  • Strong understanding of insurance and benefit design with both commercial and government payers
  • Background in Access & Reimbursement, Payer account management, Patient Services, Case Management
  • Successful navigation of complex authorization processes for diagnostic testing; unlisted cpt codes (Pre-determinations and appeals)
  • Working with a Patient Service Center/Hub to design case-specific strategies based on payer mix, benefit design, and authorization requirements
  • Coordinating case pull-through with the Market Access/Managed Care, Case Managers, Sales, and RCM Leadership
  • Field responsibilities that include supporting and educating HCP offices on best practices that streamline the authorization process and expedite treatment access for patients
  • Demonstrated analytical, problem-solving, and relationship-building skills
  • QA and QC on cases; weekly
  • Conduct monthly and routine 1:1s with staff; Mid-Year and Yearly reviews
  • Provide process improvement feedback on existing workflows

Qualifications:

  • Bachelor's or higher degree preferred; or experience related to industry
  • Minimum of 5 years of Managerial experience
  • Minimum of 5 years' experience working with diagnostic laboratory testing
  • Minimum of 3 years' access-related position (FAP, PAP)
  • Excellent communication, organizational, and leadership skills
  • Implementing measures that enable metrics for sub-team

About CareDx:

CareDx, Inc. is an Equal Opportunity Employer and participates in the E-Verify program. We offer a competitive Total Rewards package, including a gym reimbursement program, 401(k) savings plan match, Employee Stock Purchase Plan, and pre-tax commuter benefits. We also have a Living Donor Employee Recovery Policy that allows up to 30 days of paid leave annually to a full-time employee who makes the selfless act of donating an organ or bone marrow.



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