Reimbursement Triage Specialist

Company Description

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.

Job Description

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 receiving, distributing, and documenting appropriate payer and/or patient communications and/or correspondence for insurance claim research and/or appeals. Essential Duties and Responsibilities:

· Provide superior customer service by being attentive; ensures understanding of customer request; being proactive in identifying and addressing concerns or problems

· Analyze all clinical and financial information from a variety of internal and external sources (mail, email, portals, fax, CD, copying/scanning etc…)

· Process all incoming and outgoing requests electronically and manually

· Follow appropriate HIPAA guidelines by validating requests and authorizations for release of medical information to/from primary care provider, insurance carriers, referred providers and patients per patient request

· Provide reimbursement assistance to patients while providing superior customer service and respect to patients and their families

· Work well individually and in a team environment accomplishing set goals; willingly accepts assignments and is available to take on additional tasks facilities or assist with backlogs

· Review each document and determine if image/document should be uploaded as a new document, replacing a document or deleted

· Ability to accurately and efficiently utilize a computer for data input, retrieval of data, running reports and all other tasks associated with release of information services

· Attends and participates in the required educational training sessions and staff meetings as scheduled and assigned.

· Maintains equipment in excellent operating condition (inside and out) and troubleshoot equipment issues with assistance from the Help Desk department.

· Performs other related duties as assigned

Qualifications

· A minimum of 1-year recent experience in both professional and facility release of information, medical records, or other related experience in a healthcare environment, and collections with high volume and/or multiple accounts

· Experience with contacting and follow up with insurance carriers on denials, file reconsideration requests, formal appeals and negotiations (preferred)

· Must be proficient using computer software and technology, data entry, and have above average typing skills

· Intermediate to advanced MS Office including Excel

· Familiarity with laboratory billing, Xifin, Salesforce, merchant solutions, payer portals and national as well as regional payers throughout the country are a plus

· Ability to work professionally, effectively, and efficiently in a team environment with customers, management and co-workers

· Must be willing to travel to multiple Guardant campus based on the needs of the company

· High school d