Reimbursement Specialist II, Medical Records Processor (Hybrid, Onsite and Remote Options)

Company Description

Guardant Health is a leading precision oncology company focused on helping conquer cancer globally through use of its proprietary tests, vast data sets and advanced analytics. The Guardant Health oncology platform leverages capabilities to drive commercial adoption, improve patient clinical outcomes and lower healthcare costs across all stages of the cancer care continuum. Guardant Health has commercially launched Guardant360®, Guardant360 CDx, Guardant360 TissueNext™, Guardant360 Response™, and GuardantOMNI® tests for advanced stage cancer patients, and Guardant Reveal™ for early-stage cancer patients. The Guardant Health screening portfolio, including the Shield™ test, aims to address the needs of individuals eligible for cancer screening.

Job Description

(We will consider 3 days Hybrid (3 days in office), 100% Remote and Full Onsite Options)

As a Reimbursement Specialist II, Medical Records Processor, 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 work closely with physicians and hospital staff to obtain release of complete, accurate, and compliant documentation for reimbursement for services provided in a timely and efficient manner ensuring accuracy.

Essential Duties and Responsibilities but not limited to:

• Provide superior customer service by being attentive; insures understanding of customer request; being proactive in identifying and addressing concerns or problems
• Obtains appropriate clinical documentation through extensive interaction with physicians, nursing staff, medical staff, ancillary staff
• 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 request electronically and manually
• Performs quality checks on all work to assure accuracy of the patient name, date of servise, confidentiality, and proper invoicing
• Follow appropriate HIPAA guidelines by validating requests and authorizations for release of medical information to/frpm primary care provider, insurance carriers, referred providers and patients per patient request
• 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 release of information 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 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

• High school diploma or equivalent
• A minimum of 3 years 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 a 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
• Experience with contacting and follow up with insurance carriers on denials, file reconsideration requests, formal appeals and negotiations (preferred)
• Must be proficient using a 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