Reimbursement Specialist

Summary

Join Guardant Health as a Reimbursement Specialist – Follow Up and Appeals and play a vital role in driving payment for services. You will work with our billing tool provider, collaborating with Finance and Client Services to optimize billing processes. Key responsibilities include tracking and addressing outstanding claims, troubleshooting EOBs, appealing claims, and managing documentation. This role requires at least 3 years of experience in coding, billing, and collections, along with experience in insurance carrier follow-up and appeals. Proficiency in computer skills, data entry, and MS Office is essential. The position offers a hybrid work model with options for remote work, and the salary range is $20.00 to $33.75 per hour.

Requirements

• A minimum of 3 years of recent experience in professional and facility coding, billing, and collections with high volume and/or multiple accounts
• Experience contacting and following up with insurance carriers on denials, filing reconsideration requests, formal appeals, and negotiations
• Experience working with a broad range of payers and appealing to state-level agencies or external-level review with IRO/IRBs
• Basic math skills to accurately interpret payment & adjustment transactions (must be able to read & understand an EOB)
• Proficiency in computer use, data entry, and above-average typing skills
• Intermediate to advanced MS Office skills, including Excel
• High school diploma or equivalent

Responsibilities

• Accurately enter data into computer systems, including accurate account notations
• Provide reimbursement assistance to patients with superior customer service
• Resolve most patient concerns or complaints without escalation
• Verify and communicate insurance eligibility, billing, collections, and payment responsibilities to patients and their families
• Demonstrate a proven track record of successful written appeals
• Correctly interpret EOBs for follow-up and/or appeals
• Follow HIPAA guidelines when providing medical records
• Work effectively individually and in a team environment to achieve goals
• Perform other related duties as assigned

Preferred Qualifications

Familiarity with laboratory billing, Xifin, EDI enrollment, merchant solutions, payer portals, and national as well as regional payers throughout the country

Benefits

Hybrid Work Model: Options for full-time remote, 3-days hybrid, and 5-days onsite