Reimbursement Specialist II - Pre Billing
Guardant Health
Company Description
Guardant Health is a leading precision oncology company focused on guarding wellness and giving every person more time free from cancer. Founded in 2012, Guardant is transforming patient care and accelerating new cancer therapies by providing critical insights into what drives disease through its advanced blood and tissue tests, real-world data and AI analytics. Guardant tests help improve outcomes across all stages of care, including screening to find cancer early, monitoring for recurrence in early-stage cancer, and treatment selection for patients with advanced cancer. For more information, visit guardanthealth.com and follow the company on LinkedIn, X (Twitter) and Facebook.
Job Description
As a Reimbursement Specialist II, Payment Posting, you are a seasoned expert within the revenue cycle team, driving impact through deep knowledge of insurance processes, payer policy, and driving payment for our services. You play a key role in partnering with colleagues in Finance and Client Services while maximizing reimbursement outcomes for the organization. You will facilitate optimized billing processes and operations that are aligned with Guardant Health’s mission and values.
You will independently manage posting cash receipts and EOBs in the billing tool and ensure that daily cash from the lockbox is reconciled to patient accounts efficiently and accurately. With your extensive background in healthcare billing and payer engagement, strong attention to detail is critical. Strong communication and troubleshooting skills are required to manage unbalanced remittance advice directly with payers.
You’ll help build and maintain comprehensive documentation of payer requirements and support process improvement initiatives that increase efficiency and effectiveness across the department.
Key Responsibilities:
- Analyze and interpret details from EOB/ERA files to ensure accurate posting of payments and adjustments against appropriate line-item service in a timely manner.
- Posting all denied charges for appeals department
- In-depth knowledge of healthcare remark/ reason codes, advice codes, and definitions
- Familiarity with credits, debits, adjustments, takebacks, patient responsibility, allowed amounts, deductibles, co-pays, and coinsurance
- Understanding of denied charges, denial reasons, and claims adjudication processes
- Allocating Patient Payments to the appropriate account in a timely manner
- Manage credit card transactions including credits, refunds, and chargebacks
- Reconciling all bank transactions while meeting monthly deadlines
- Daily, monthly, quarterly, and annually reconcile credits and debit transactions received by the financial institution.
- Manage incoming correspondence from various channels (fax, email, portal) and associate them with the relevant patient/insurance records.
- Communicate effectively with cross-functional teams to identify and address inefficiencies impacting ASP and claims adjudication processes.
- Investigate and resolve credit balances, missing payments, payment allocations or discrepancies related to claims/appeals.
Qualifications
- 2-4 years recent experience in both professional and facility health care claims posting, including knowledge of health plan regulations and processes with high volume and/or multiple accounts.
- Experience with contacting and follow up with insurance carriers; national as well as regional payers throughout the country.
- Experience with managing incoming transactions from multiple lockboxes, ACH credit/debits, wire transfers, manage credit card processing with multiple gateways and merchant accounts as well as check scanners.
- Proficiency with revenue cycle tools, experience with laboratory reimbursement workflows, EDI enrollment, Payer Portal setup & management, Telcor, Waystar Clearinghouse, and Sarbanes Oxley controls (SOX) are requirements is highly desirable.
- Exceptional attention to detail, self-motivated, organizational abilities and driven to identify process improvements that enhance operational performance.
- Demonstrated proficiency with using computer hardware and PC software, specifically Microsoft Office Suite, Adobe Acrobat PDF, particularly Excel, and have above average typing skills
- Ability to work independently and handle confidential and sensitive information with utmost discretion.
- Excellent communication and interpersonal skills to facilitate collaboration across department, with an ability to distill complex issues for both technical and non-technical audiences.
- This role may require some travel.
Additional Information
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. We have found aligning our scheduled in-office days allows our teams to do the best work and creates the focused thinking time our innovative work requires. At Guardant, our work model has created flexibility for better work-life balance while keeping teams connected to advance our science for our patients.
The US hourly range for this full-time position is $22.39 to $30.79. The range does not include benefits and, if applicable, overtime, bonus, commission, or equity. The range displayed reflects the minimum and maximum target for new hire salaries across all US locations for the posted role with the exception of any locations specifically referenced below (if any).
Within the range, individual pay is determined by work location and additional factors, including, but not limited to, job-related skills, experience, and relevant education or training. If you are selected to move forward, the recruiting team will provide details specific to the factors above.
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 committed to providing reasonable accommodations in our hiring processes for candidates with disabilities, long-term conditions, mental health conditions, or sincerely held religious beliefs. If you need support, please reach out to [email protected]
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.
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.
Please visit our career page at: http://www.guardanthealth.com/jobs/