Reimbursement Triage Specialist
About The Position
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. As a Reimbursement Triage Specialist, 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 are responsible for documenting appropriate payer communication and/or correspondence for insurance claim research and/or appeals. Strong communication and troubleshooting skills are required.
Requirements
- A minimum of 1-year recent experience in both professional and facility billing, and collections with high volume and/or multiple accounts
- Proficiency in managing emails, voicemails, and faxes in a fast-paced environment.
- Basic math skills to accurately interpret payment & adjustment transactions (must be able to read & understand an EOB)
- Must be proficient using a computer, data entry, and have above average typing skills
- Intermediate to advanced MS Office including Excel
- High school diploma or equivalent
Nice To Haves
- Experience with contacting and follow up with insurance carriers on denials, file reconsideration requests, formal appeals and negotiations (preferred)
- Familiarity with laboratory billing, Xifin, Telcor, EDI enrollment, merchant solutions, payer portals and national as well as regional payers throughout the country are a plus
Responsibilities
- Provide reimbursement assistance to patients while providing superior customer service and respect to patients and their families
- Correctly interpret EOB’s for follow-up and/or appeals
- Oversee all incoming and outgoing mail via USPS, FedEx, and other shipping carriers, ensuring timely and accurate processing
- Support the management of incoming faxes, ensuring they are directed to the correct patient account and department where applicable
- Manage incoming department emails and triage voicemails, delegating them to the correct department or individual as needed
- Work with insurance portals to import and export documents for claims and appeals, ensuring accuracy and compliance with procedures
- Follow appropriate HIPAA guidelines provide medical records to primary care provider, insurance carriers, referred providers and patients per patient request
- Work well individually and in a team environment accomplishing set goals
- Performs other related duties as assigned to support the overall efficiency of the department
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
