Reimbursement Specialist - Insurance Verification

Naveris • Waltham, MA

6d • Remote

About The Position

Would you like to be part of a fast-growing team that believes no one should have to succumb to viral-mediated cancers? Naveris, a commercial stage, precision oncology diagnostics company with facilities in Boston, MA and Durham, NC, is looking for a Reimbursement Specialist – Insurance Verification team member to help us advance our mission of developing and delivering novel diagnostics that transform cancer detection and improve patient outcomes. Our flagship test, NavDx, is a breakthrough blood-based DNA test for HPV cancers, clinically proven and already trusted by thousands of physicians and institutions across the U.S. Opportunity We are looking for a conscientious, detail-oriented Reimbursement Specialist – Insurance Verification to join our team and support front-end reimbursement activities. While Naveris partners with an outsourced RCM vendor, this role focuses on ensuring accurate insurance verification, benefits investigation, and documentation to support timely and accurate billing across Medicare, Medicaid, and commercial insurance plans.

Requirements

• 4+ years of experience in reimbursement, insurance verification, or revenue cycle management within a diagnostics company, laboratory, or commercial payer environment
• Bachelor’s degree or equivalent experience
• Strong understanding of medical benefit structures, including Federal, State, PPO, HMO, and indemnity plans
• Working knowledge of CPT, ICD-10, and HCPCS coding, as well as LCD/NCD coverage guidelines
• Strong problem-solving skills with attention to detail, judgment, and follow-through
• Excellent verbal and written communication skills with a strong customer service orientation
• Strong troubleshooting, organizational, and time-management skills
• Ability to adapt to changing business needs
• Self-starter who can work independently

Nice To Haves

• Experience with Xifin, Quadax, or Telcor preferred

Responsibilities

• Verify patient insurance coverage, eligibility, and benefits by contacting payers and using electronic verification tools
• Accurately enter and maintain patient demographic and insurance information in billing systems and payer portals
• Obtain medical records or supporting documentation for priority payers when not received with the order
• Collaborate with internal teams, healthcare providers, insurance companies, and patients to gather information needed for accurate billing
• Identify front-end delays or issues impacting reimbursement and recommend solutions
• Maintain detailed and accurate documentation of eligibility verification and payer communications
• Communicate with patients to explain insurance-related processes, benefit coverage, EOBs, and financial responsibility for non-clinical inquiries
• Maximize utilization of systems, tools, and resources to support front-end reimbursement activities
• Review payer correspondence and EOBs to validate coverage determinations and identify discrepancies related to eligibility or benefits
• Ensure compliance with all Federal and State billing regulations and company policies, including HIPAA
• Fully remote role (U.S.-based) with occasional travel for trainings, meetings, or on-site presence at headquarters.
• Travel requirement: up to 5%.

Benefits

• In addition to our great team and advanced medical technology, we offer our employees competitive compensation, work/life balance, remote work opportunities, and more!

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Number of Employees: 11-50 employees