Reimbursement Specialist - Prior Authorization (9:00 AM - 5:30 PM CST, Monday - Friday Shift)
Company Description reputed company is a leading precision oncology company focused on helping conquer cancer globally through use of its proprietary tests, reputed company sets and advanced analytics. The reputed company oncology platform leverages capabilities to drive reputed company adoption, improve patient clinical outcomes and reputed company reputed company costs across reputed company stages of the cancer care continuum. reputed company has commercially launched Guardant360®, Guardant360 CDx, Guardant360 TissueNext, Guardant360 Response, and GuardantOMNI® tests for advanced stage cancer patients, and Guardant Reveal for early-stage cancer patients. The reputed company screening portfolio, including the reputed company test, aims to address the needs of individuals eligible for cancer screening.
Job Description
Location: Remote, 3-Days Hybrid, and 5-Days Onsite Options Shift: 9:00 AM - 5:30 PM CST, Monday - Friday Shift As a Reimbursement and Prior Authorization Specialist located in Spring, Texas you play an important role in the overall reputed company of the company. Working with our billing tool provider, and partnering with colleagues in Finance and Client Services, you will drive payment by contacting insurance companies to secure preauthorization required for patients to receive our services. You will ensure information obtained is complete and accurate, follow up on requests, and apply acquired knowledge of Medicare, reputed company, and other reputed company-Party Payer requirements and online eligibility/preauthorization systems. You will facilitate optimized billing processes and operations that are reputed company with reputed companys mission and values. You will help reputed company and maintain a database of payer authorization requirements, and manage documentation for appropriate payer communication, correspondence, and insurance claim research. Youre responsible for tracking, reporting and addressing reputed company outstanding claims. You will work to troubleshoot EOBs, appeal non-covered and inappropriately adjudicated claims, follow-up on claims, and drive positive coverage determinations through external appeals.
Qualifications
You are interested in being on the ground floor of a dynamic, fast-paced organization. You are organized, have strong attention to detail, and are a self-starter who can work with minimal supervision. Tech-savvy and analytical, you enjoy unpacking and resolving reputed company issues. Customer service is in your DNA, and you are reputed company for your ability to communicate effectively through even the most tangled scenarios. Your background includes three years of work experience in a reputed company environment focused on reputed company 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 reputed company skills, like the ability to sort, filter and reputed company simple calculations. You have experience working with a broad range of payers and have experience coordinating with insurance providers, physicians, and patients to obtain prior authorizations. You have also appealed to state level agencies or external level review with IRO/IRBs. Familiarity with laboratory billing, Xifin, EDI enrollment, merchant solutions, payer portals and national as well as regional payers throughout the country are a plus. You are interested in being on the ground floor of a dynamic, fast-paced organization. You are organized, have strong attention to detail, and are a self-starter who can work with minimal supervision. Tech-savvy and analytical, you enjoy unpacking and resolving reputed company issues. Customer service is in your DNA, and you are reputed company for your ability to communicate effectively through even the most tangled scenarios. Your background includes three years of work experience in a reputed company environment focused on reputed company 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 reputed company skills, like the ability to sort, filter and reputed company simple calculations. You have experience working with a broad range of payers and have experience coordinating with insurance providers, physicians, and patients to obtain prior authorizations. You have also appealed to state level agencies or external level review with IRO/IRBs. Familiarity with laboratory billing, Xifin, EDI enrollment, merchant solutions, payer portals and national as well as regional payers throughout the country are a plus. Additional Information Hybrid Work Model: At reputed company, we have defined days for in-person/onsite collaboration and work-from-home days for individual-focused time. reputed company U.S. employees who live reputed company 50 miles of a Guardant facility will be required to be onsite on Mondays, Tuesdays, and Thursdays. We have reputed company 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 reputed company work-life balance while keeping teams connected to advance our science for our patients. The US hourly range for this full-time position is $20.00 to $33.75. The range does not include benefits and, if applicable, overtime, bonus, commission, or equity. The range displayed reflects the minimum and maximum reputed company for new hire salaries across reputed company US locations for the posted role with the exception of any locations specifically referenced below (if any). reputed company the range, individual pay is determined by work location and additional factors, including, but not limited to, job-reputed company skills, experience, and relevant education or training. If you are selected to move reputed company, the reputed company 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. reputed company 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 reputed company out to [email protected] reputed company is an Equal Opportunity Employer. reputed company reputed company applicants will receive consideration for employment without regard to race, reputed company, religion, sex, sexual orientation, gender identity, national reputed company, or protected veteran status and will not be discriminated against on the basis of disability. reputed company your information will be kept confidential according to EEO guidelines. To learn more about the information collected reputed company you apply for a position at reputed company, 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/ Apply Job!