Reimbursement Specialist - Order Entry (Remote, 3-Days Hybrid, and 5-Days Onsite Options - 9:30 AM - 6:00 PM PST, Tuesday through Saturday Shift)

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

Shift Schedule: 9:30 AM to 6 PM PST, Tuesday through Saturday

As a Reimbursement Specialist, Order Entry, 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’re responsible for incoming demographics entry into the billing tool and clean claims submissions using a HCFA 1500 claims form or electronic equivalent. Incoming demographics information will be transferred from LIMS/LIS portal to the billing tool and checked for eligibility prior to claim submission. Troubleshooting front-end denials of electronic claims using payer portals will ensure that tests are billed in a timely manner to payers.

Essential Duties and Responsibilities:

• Processing a high volume of 500+ patients demographics entries into the billing tool daily.
• Accurate data entry of information into computer systems including notating accounts accurately to ensure the best patient experience.
• Quality control of daily entries into the billing tool through cross-referencing internal intelligence to ensure the highest level of accuracy.
• Creation and set up of insurance plan types in the Xifin billing platform for clean claim submission using a HCFA 1500 claim form or the electronic equivalent.
• Follow appropriate HIPAA guidelines to use electronic payor portals to verify patient insurance eligibility.
• Follow appropriate HIPAA guidelines to translate patient insurance information into the billing tool and communicate patient insurance information with insurance providers.
• Accurate identification and assignment of billing codes to patient orders to generate anticipated price markers.
• Work well individually and in a team environment accomplishing set goals.
• Performs other related duties as assigned.

Qualifications

• A minimum of 1-year recent experience in both professional and facility billing, and collections with high volume and/or multiple accounts
• Accurate identification of insurance and plan types
• Experience with contacting and following up with insurance carriers on front-end rejections is preferred.
• Must be proficient in using a computer, accurate data entry, and have above-average typing skills.
• Intermediate to advanced MS Office including Excel.
• Familiarity with laboratory billing, Xifin, EDI enrollment, payer portals, and national as well as regional payers throughout the country is a plus.
• High school diploma or equivalent

Work Environment:

Employees may be required to lift routine office supplies and use office equipment. Majority of the work is performed in a desk/office environment; however, there may be exposure to high noise levels, fumes, and biohazard material in the laboratory environment. Ability to sit for extended periods of time.

Additional Information