Reimbursement Specialist, Medical Records Processor

Summary

Join Guardant Health as a Reimbursement Specialist, Medical Records Processor, and play a vital role in ensuring timely payments for services. You will collaborate with physicians, hospital staff, and internal teams to obtain accurate medical documentation for reimbursement. This position requires strong communication and organizational skills, proficiency in computer software, and experience in medical records or related healthcare fields. The role offers a hybrid work model with a mix of in-office and remote work options, and the opportunity to contribute to a company focused on precision oncology. The position requires a minimum of one year of experience in release of information, medical records, or collections in a healthcare setting. The salary range is competitive and varies based on location and experience.

Requirements

• High school diploma or equivalent
• A minimum 1 year recent experience in both professional and facility release of information, medical records, or other related experience in a healthcare environment, and collections with high volume and/or multiple accounts
• Must be proficient using computer software and technology, data entry, and have above average typing skills
• Intermediate to advanced MS Office including Excel
• Ability to work professionally, effectively, and efficiently in a team environment with customers, management and co-workers
• Must be willing to travel to multiple Guardant campus based on the needs of the company

Responsibilities

• Provide superior customer service by being attentive; insure understanding of customer request; be proactive in identifying and addressing concerns or problems
• Obtain appropriate clinical documentation through extensive interaction with physicians, nursing staff, medical staff, ancillary staff
• Analyze all clinical and financial information from a variety of internal and external sources (mail, email, portals, fax, CD, copying/scanning etc…)
• Process all incoming and outgoing request electronically and manually
• Perform quality checks on all work to assure accuracy of the patient name, date of service, confidentiality, and proper invoicing
• Follow appropriate HIPAA guidelines by validating requests and authorizations for release of medical information to/from primary care provider, insurance carriers, referred providers and patients per patient request
• Work well individually and in a team environment accomplishing set goals; willingly accepts assignments and is available to take on additional tasks facilities or assist with release of information backlogs
• Review each document and determine if image/document should be uploaded as a new document, replacing a document or deleted
• Ability to accurately and efficiently utilize a computer for data input, retrieval of data, running reports and all other tasks associated with release of information services
• Attend and participate in required educational training sessions and staff meetings as scheduled and assigned
• Maintain equipment in excellent operating condition (inside and out) and troubleshoot equipment issues with assistance from the Help Desk department
• Perform other related duties as assigned

Preferred Qualifications

• Experience with contacting and follow up with insurance carriers on denials, file reconsideration requests, formal appeals and negotiations
• Familiarity with laboratory billing, Xifin, Salesforce, merchant solutions, payer portals and national as well as regional payers throughout the country

Benefits

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