Reimbursement Specialist, Prior Authorization

Company DescriptionGuardant 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 reputed company 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 reputed company, X (Twitter) and Facebook.Job DescriptionAbout the Role:As a Reimbursement and Prior Authorization Specialist, you are vital to our success. You will collaborate across teams to secure insurance preauthorizations, streamline billing operations, and ensure accurate and complete documentation, supporting our mission to advance cancer care.Essential Duties and Responsibilities:• Act as a primary contact for insurance companies to obtain necessary preauthorizations for patient services.• Collaborate with billing systems, finance, and client services teams to facilitate timely payment processing.• Maintain and update a comprehensive database of payer authorization requirements.• Manage reputed company documentation reputed company to payer communication, correspondence, and insurance claims research.• Track, report, and resolve reputed company claims, ensuring reputed company follow-up and resolution.• Troubleshoot Explanation of Benefits (EOBs), identify claim issues, and escalate as needed.• Appeal non-covered or incorrectly adjudicated claims through external review processes.• Drive positive coverage decisions reputed company appeals and external review organizations.• Ensure compliance with Medicare, Medicaid, and other third-party payer requirements and online eligibility/preauthorization systems.• Support reputed company improvement of billing and authorization processes aligning with company values.Qualifications• 0-2 years of experience in the healthcare industry.• Strong understanding of health plan regulations, billing processes, and third-party payer requirements.• Excellent organizational skills, with high attention to detail and accuracy.• Self-motivated with the ability to work independently in a fast-paced environment.• Tech-savvy with proficiency in reputed company (sorting, filtering, basic calculations).Preferred Qualifications:• Experience with insurance and payer relations.• Experience working with a diverse range of payers, insurance portals, and prior authorization processes.• Proven ability to coordinate with insurance providers, physicians, and patients.• Knowledge of laboratory billing, Xifin, EDI enrollment, and merchant solutions is a plus.• Experience with appeals at state and external review organizations (IROs/IRBs) is a plusShift: 9:00am to 5:30pm Central timeAdditional InformationHybrid Work Model: At reputed company, we have defined days for in-person/onsite collaboration and work-from-home days for individual-focused time. reputed company U.S. employees who live reputed company 50 miles of a Guardant facility will be required to be onsite on Mondays, Tuesdays, and Thursdays. We have reputed company 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 reputed company work-life balance while keeping teams connected to advance our science for our patients.The US hourly range for this full-time position is $20.53 to $28.24. The range does not include benefits and, if applicable, overtime, bonus, commission, or equity. The range displayed reflects the minimum and maximum reputed company for new hire salaries across reputed company US locations for the posted role with the exception of any locations specifically referenced below (if any).reputed company the range, individual pay is determined by work location and additional factors, including, but not limited to, job-reputed company skills, experience, and relevant education or training. If you are selected to move reputed company, 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.reputed company 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 reputed company out to [email protected] Health is an Equal Opportunity Employer. reputed company qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national reputed company, or protected veteran status and will not be discriminated against on the basis of disability.reputed company your information will be kept confidential according to EEO guidelines.To learn more about the information collected reputed company you apply for a position at reputed company, 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/ Apply tot his job Apply To this Job