Reimbursement Specialist II

New

Guardant HealthPrecision oncology

Source API remote eligibility restrictions: United StatesFull-TimeMiddle

Salary23 - 31 USD per year

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Job Details

Have a minimum of 3–5 years of recent experience in professional and facility coding, billing, and collections with high volume and/or multiple accounts.
Have experience contacting and following up with insurance carriers on denials, filing reconsideration requests and formal appeals, and negotiating.
Have experience with a broad range of payers and appeals to state-level agencies or external-level review with IRO/IRBs.
Have experience working with Medicare and Medicaid.
Use basic math skills to interpret payment and adjustment transactions and read and understand EOBs.
Be proficient with computers and data entry and have above-average typing skills.
Have intermediate to advanced MS Office skills, including Excel.
Have a high school diploma or equivalent.
Familiarity with laboratory billing, Xifin, EDI enrollment, merchant solutions, and payer portals is a plus.

Track, report, and address complex outstanding claims.
Troubleshoot EOBs and follow up on claims.
Appeal non-covered and low-pay claims and pursue positive coverage determinations through external appeals.
Manage documentation for payer communication, correspondence, and insurance claim research.
Enter information accurately into computer systems and notate accounts.
Provide reimbursement assistance to patients and respond to concerns or complaints.
Verify and communicate insurance eligibility, billing, collections, and payment responsibilities to patients and their families.
Interpret EOBs for follow-up and appeals.
Provide medical records to providers, insurance carriers, and patients in accordance with HIPAA guidelines.

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