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Reimbursement Specialist, Follow-Up and Appeals

Company: Guardant Health, Inc.
Location: Redwood City
Posted on: June 8, 2021

Job Description:

Guardant Health is a leading precision oncology company focused on helping conquer cancer globally through use of its proprietary blood tests, vast data sets and advanced analytics. The Guardant Health Oncology Platform leverages capabilities to drive commercial adoption, improve patient clinical outcomes and lower healthcare costs across all stages of the cancer care continuum. Guardant Health has launched liquid biopsy-based Guardant360, Guardant360 CDx and GuardantOMNI tests for advanced stage cancer patients. These tests fuel development of its LUNAR program, which aims to address the needs of early-stage cancer patients with neoadjuvant and adjuvant treatment selection, cancer survivors with surveillance, asymptomatic individuals eligible for cancer screening and individuals at a higher risk for developing cancer with early detection.

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This role works out of our Headquarters in Redwood City, CA.

Due to the Covid 19 Pandemic Guardant Health has temporarily classified this role as 'working from home status,' scheduled to return onsite at HQ when it is determined safe to do so.

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The Reimbursement Operations Team at Guardant Health is committed to building for the future, focusing on optimizing billing and reimbursement and ensuring we stay true to our company mission and values in the process.

As a Reimbursement Specialist - Follow up and Appeals, you play an important role in the overall success of the company. Working with our billing tool provider, you will drive payment for our services, and by partnering with colleagues in Finance and Client Services. You will facilitate optimized billing processes and operations that are aligned with Guardant Health's mission and values.

You're responsible for tracking, reporting and addressing complex outstanding claims. You will work to troubleshoot EOBs, appeal non-covered & low pay claims, follow-up on claims, and drive positive coverage determinations through external appeals. You will manage documentation for appropriate payer communication, correspondence, and insurance claim research.

  • You are interested in being on the ground floor of a dynamic, fast paced organization.
  • Strong organizational skills with strong attention to detail, self-starter and can work with minimal supervision.
  • Tech savvy and analytical, you enjoy unpacking and resolving complex issues.
  • Customer service is in your DNA, and you are known for your ability to communicate effectively through even the most tangled scenarios.
  • Experience includes three years of work experience in a healthcare environment focused on healthcare reimbursement, including knowledge of health plan regulations and processes.
  • Previous experience in similar roles enables you to hit the ground running and contribute insights and solutions to your team.
  • Moderate Excel skills, the ability to sort, filter and perform simple calculations required.
  • Experience working with a broad range of payers and have appealed to state level agencies or external level review with IRO/IRBs.
  • Familiarity with laboratory billing, Xifin, EDI enrollment, merchant solutions, payer portals and national as well as regional payers throughout the country are a plus.

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 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.

Please visit our career page at: http://www.guardanthealth.com/jobs/

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.

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Keywords: Guardant Health, Inc., Redwood City , Reimbursement Specialist, Follow-Up and Appeals, Other , Redwood City, California

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