Senior Reimbursement Specialist - Prior Authorization - Remote

Overview

The Senior Reimbursement Specialist plays a crucial role in driving the financial success of Guardant Health by managing the prior authorization lifecycle, optimizing billing operations, and resolving complex reimbursement issues.

In Short

• Manage the full prior authorization process ensuring timely approvals.
• Collaborate with billing tool providers to enhance efficiency.
• Resolve complex denials and reimbursement challenges.
• Facilitate communication with physician offices and internal teams.
• Maintain accurate documentation for payer communications.
• Develop training and quality control programs.
• Collaborate with offshore teams on prior authorization cases.
• Verify and communicate insurance eligibility and billing details.
• Draft and submit written appeals successfully.
• Adhere to HIPAA guidelines when handling medical records.

Requirements

• Minimum 5+ years experience in coding, billing, and prior authorization.
• Experience with insurance denials and appeals.
• Proficient in MS Office, especially Excel.
• Familiarity with laboratory billing and payer portals is a plus.
• High school diploma or equivalent; bachelor’s degree preferred.

Benefits

• Flexible hybrid work model for better work-life balance.
• Competitive salary range based on location and experience.
• Opportunities for professional development and training.
• Supportive work environment focused on innovation.
• Equal opportunity employer with commitment to diversity.