Senior Reimbursement Specialist - Order Entry (Tuesday - Saturday 9:00 AM PST - 6:00 PM PST)

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 Senior Reimbursement Specialist - Order Entry, you will play a key role in ensuring accurate and timely claims submission and reimbursement processing to support the financial health of Guardant Health. Leveraging your expertise in billing systems, insurance guidelines, and reimbursement strategies, you will serve as a subject matter expert and mentor within the billing operations team. You will collaborate closely with internal teams including Finance, Client Services, and Laboratory Operations, as well as with our billing platform provider, to optimize order entry workflows and reimbursement outcomes.

In this senior-level role, you will be responsible for managing complex claim issues, resolving high-impact front-end rejections, and contributing to the development and enhancement of processes and documentation. You will lead efforts in quality assurance and process improvement and may assist in onboarding and training of junior team members.

Key Responsibilities:

• Lead and execute the accurate entry of incoming demographics into the billing tool and ensure timely, clean claims submissions using the HCFA 1500 form or electronic equivalent.
   
• Serve as a primary escalation point for complex or high-priority claims issues and front-end denials, working directly with payer portals to troubleshoot and resolve issues efficiently.
   
• Perform comprehensive eligibility verification and coordination of benefits to ensure claims accuracy prior to submission.
   
• Maintain a high level of accuracy in data entry and account notations across multiple billing systems.
   
• Provide expert-level reimbursement guidance and support to patients, demonstrating empathy, professionalism, and superior customer service.
   
• Collaborate with cross-functional teams to support initiatives related to payer engagement, claim edits, and process improvements.
   
• Ensure full compliance with HIPAA and all applicable regulatory standards; manage medical record requests for patients, payers, and providers as needed.
   
• Identify opportunities for operational efficiencies and contribute to the development and refinement of SOPs and best practices.
   
• Support training, mentoring, and knowledge sharing among junior team members.
   
• Participate in audits and other special projects as assigned.

Qualifications

•  
• 3–6 years of recent experience in high-volume professional and/or facility billing and reimbursement, with demonstrated expertise in order entry and claims submission processes.
   
• Proven ability to handle complex payer issues, front-end rejections, and escalated reimbursement inquiries with minimal oversight.
   
• Strong proficiency in billing platforms and payer portals; experience with laboratory billing systems such as Xifin is highly preferred.
• Strong experience with Salesforce or similar CRM.
   
• High level of comfort with Excel and Microsoft Office Suite; ability to analyze data and create process reports or summaries as needed.
   
• Strong knowledge of