Reimbursement Specialist - Medical Records Processor (9:00 AM - 6:00 PM PST, Monday - Friday Shift)

  • Full-time

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

Location: Onsite, Hybrid or Remote Options available

Shift: 9:00 AM - 6:00 PM PST, Monday - Friday Shift

As a Reimbursement Specialist, 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 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 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
  • 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

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.

While role is hybrid, training will be virtual and onsite; candidate will need to be able to come into the office from time to 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.

The US hourly range for this full-time position is $20.00 to $33.75. The range does not include benefits and, if applicable, overtime, bonus, commission, or equity. The range displayed reflects the minimum and maximum target for new hire salaries across all US locations for the posted role with the exception of any locations specifically referenced below (if any).

For positions based in Palo Alto, CA or Redwood City, CA, the hourly range for this full-time position is $25.00 to $42.21. The range does not include benefits and, if applicable, overtime, bonus, commission, or equity.

Within the range, individual pay is determined by work location and additional factors, including, but not limited to, job-related skills, experience, and relevant education or training. If you are selected to move forward, the recruiting team will provide details specific to the factors above.

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.

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

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