Reimbursement Specialist, Follow-Up and Appeals (HYBRID or REMOTE)
Company: Guardant Health
Location: San Jose
Posted on: May 16, 2022
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.
As aReimbursement 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. You are organized and have strong attention to
detail, are a 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
Your background includes three years of work experience in a
healthcare environment focused on healthcare reimbursement,
including knowledge of health plan regulations and processes. Your
previous experience in similar roles enables you to hit the ground
running and contribute insights and solutions to your team.
You should have moderate Excel skills, like the ability to sort,
filter and perform simple calculations. You have experience working
with a broad range of payers and have appealed to state level
agencies or external level review with IRO/IRBs.
Employee may be required to lift routine office supplies up to 25
lbsand 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.
Familiarity with laboratory billing, Xifin, EDI enrollment,
merchant solutions, payer portals and national as well as regional
payers throughout the country are a plus.
Covid Vaccination Policy:Starting January 7, 2022, Guardant Health
will require all employees to be fully vaccinated to either (a)
establish that they have been fully vaccinated against COVID-19; or
(b) request and obtain an approved exemption from Guardant's
COVID-19 U.S. Vaccination Policy as a reasonable accommodation, as
consistent with applicable laws.Anemployee is considered fully
vaccinated against COVID-19 two weeks after receiving the second
dose of a two-dose vaccine or one dose of a single-dose
vaccination. Acceptable vaccines are approved or under emergency
use authorization by the U.S. Food and Drug Administration (FDA)
and/or the World Health Organization (WHO). In addition,
fully-vaccinated employees will be required to maintain their
fully-vaccinated status under this policy by obtaining, if
applicable, any FDA-approved boosters.
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
To learn more about the information collected when you apply for a
position at Guardant Health, Inc. and how it is used, please review
ourPrivacy Notice for Job Applicants.
Please visit our career page
Keywords: Guardant Health, San Jose , Reimbursement Specialist, Follow-Up and Appeals (HYBRID or REMOTE), Other , San Jose, California
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