Reimbursement Specialist, Payment Posting (Onsite, Hybrid or Remote Options)

  • Full-time

Company Description

Guardant Health is a leading precision oncology company focused on helping conquer cancer globally through use of its proprietary blood 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 launched liquid biopsy-based Guardant360®, Guardant360 CDx and GuardantOMNI® tests for advanced stage cancer patients. These tests fuel development of its LUNAR program, which aims to address the needs of early stage cancer patients with neoadjuvant and adjuvant treatment selection, cancer survivors with surveillance, asymptomatic individuals eligible for cancer screening and individuals at a higher risk for developing cancer with early detection.

Job Description

As a Reimbursement Specialist, Payment Posting, 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 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 ensuring efficient and accurate provider enrollment applications are submitted to medical insurance carriers in a timely manner.   

Essential Duties and Responsibilities:

  • Provide billing and reimbursement assistance to patients while providing superior customer service and respect to patients and their families
  • Accurate data entry of information into computer systems including notating accounts accurately
  • Effectively verify and communicate to patients and their families insurance eligibility, billing, collections and payment responsibilities
  • Work well individually and in a virtual environment accomplishing set goals
  • Correctly interpret Insurance Correspondence for allocating insurance responses from Explanation of Benefits (EOB) against appropriate line item service and enter adjustments as indicated; Posting all denied charges for appeals department
    • Sources of documentation that may be used to resolve balance discrepancy include, but are not limited to, the following information sources:
      • Electronic Remittance Advices (ANSI 835 ERA files)
      • Hardcopy remittance advice/EOBs received from the bank via lockbox batches
  • Works effectively and efficiently with other departments to resolve issues and correct Cash Posting errors
  • Complete, submit, and tracks Clearinghouse applications for Claim Submission (EDI) and Electronic Remittance Advice (ERA)
  • Complete EFT authorization documents to enable payment between client and carrier
  • Works closely with the Manager, Credentialing Services, Implementation Vendors to ensure the timely onboarding/enrollments of new providers and the ongoing re-enrollment/validation of existing providers
  • Advise Team Lead and/or Collection Rep of denied charges, rejected claims or any other issues that affect reimbursement.
  • Document additional necessary information for explanation of benefits (EOB) clear and accurate manner to insure others can follow documentation.
  • Allocating Patient Payments to the appropriate account in a timely manner
  • Analyzing Bank Lockbox and ACH transactions and applying cash using Xifin software
  • Collaborating with A/R staff to locate and process missing payments
  • Unapplied Payment and Error Remit Reports
  • Identifying and reporting trends by Payer
  • Reconciling all cash while meeting monthly deadlines
  • Quickly interpreting insurance payments and EOBs that may include errors
  • Maintain the strictest confidentiality; adhere to all HIPAA guidelines/regulations
  • Performs other related duties as assigned:

Qualifications

  • A minimum 2 years of recent experience in both professional and facility billing and collections with high volume and/or multiple accounts
  • Experience with contacting and following up with insurance carriers on denials, file reconsideration requests, formal appeals and negotiations (preferred)
  • Basic math skills to accurately interpret payment & adjustment transactions (must be able to read & understand an EOB)
  • Must be proficient using a computer, data entry, and have above average typing skills
  • Intermediate to advanced MS Office including Excel
  • Familiarity with laboratory billing, Xifin, EDI enrollment, merchant solutions, payer portals and national as well as regional payers throughout the country are a plus
  • High school diploma or equivalent

Work Environment:

Employee 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

Hybrid Work Model: At Guardant Health, we have defined days for in-person/onsite collaboration and work-from-home days for individual-focused time. All U.S. employees who live within 50 miles of a Guardant facility will be required to be onsite on Mondays, Tuesdays, and Thursdays. We have found aligning our scheduled in-office days allows our teams to do the best work and creates the focused thinking time our innovative work requires. At Guardant, our work model has created flexibility for better work-life balance while keeping teams connected to advance our science for our patients.

Covid Vaccination Policy:  Starting January 7, 2022, Guardant Health will require all employees to be fully vaccinated to either (a) establish that they have been fully vaccinated against COVID-19; or (b) request and obtain an approved exemption from Guardant’s COVID-19 U.S. Vaccination Policy as a reasonable accommodation, as consistent with applicable laws.  An employee is considered fully vaccinated against COVID-19 two weeks after receiving the second dose of a two-dose vaccine or one dose of a single-dose vaccination. Acceptable vaccines are approved or under emergency use authorization by the U.S. Food and Drug Administration (FDA) and/or the World Health Organization (WHO). In addition, fully-vaccinated employees will be required to maintain their fully-vaccinated status under this policy by obtaining, if applicable, any FDA-approved boosters.

Employee 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.

Guardant Health is committed to providing reasonable accommodations in our hiring processes for candidates with disabilities, long-term conditions, mental health conditions, or sincerely held religious beliefs. If you need support, please reach out to [email protected]

Guardant Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, or protected veteran status and will not be discriminated against on the basis of disability.

All your information will be kept confidential according to EEO guidelines.

To learn more about the information collected when you apply for a position at Guardant Health, Inc. and how it is used, please review our Privacy Notice for Job Applicants.

Please visit our career page at: http://www.guardanthealth.com/jobs/

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