Reimbursement Specialist I - Prior Authorization - Remote

Overview

As a Reimbursement and Prior Authorization Specialist at Guardant Health, you will play a crucial role in securing insurance preauthorizations, streamlining billing operations, and ensuring accurate documentation to support advancements in cancer care.

In Short

• Act as primary contact for insurance companies for preauthorizations.
• Collaborate with billing systems and finance teams.
• Maintain a database of payer authorization requirements.
• Manage documentation related to payer communication and claims.
• Track and resolve complex claims with prompt follow-up.
• Troubleshoot EOBs and escalate claim issues.
• Appeal non-covered claims through external review processes.
• Ensure compliance with payer requirements and eligibility systems.
• Support continuous improvement of billing processes.
• Work in a hybrid model with defined in-office and remote days.

Requirements

• 0-2 years of experience in healthcare.
• Strong understanding of health plan regulations.
• Excellent organizational skills and attention to detail.
• Self-motivated and able to work independently.
• Proficient in Excel for basic calculations.
• Experience with insurance and payer relations preferred.
• Ability to coordinate with insurance providers and patients.
• Knowledge of laboratory billing and appeals is a plus.

Benefits

• Flexible hybrid work model for better work-life balance.
• Competitive hourly salary range.
• Opportunities for professional growth.
• Supportive team environment.
• Commitment to diversity and inclusion.