Company Description|Job 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 & advanced analytics. Its Guardant Health Oncology Platform is designed to leverage its capabilities in technology, clinical development, regulatory & reimbursement to drive commercial adoption, improve patient clinical outcomes & lower healthcare costs. In pursuit of its goal to manage cancer across all stages of the disease, Guardant Health has launched multiple liquid biopsy-based tests, Guardant360 & GuardantOMNI, for advanced stage cancer patients, which fuel its LUNAR development programs for recurrence & early detection. Since its launch in 2014, Guardant360 has been used by more than 6,000 oncologists, over 50 biopharmaceutical companies & all 27 of the National Comprehensive Cancer Network centers.
As a Reimbursement andPrior Authorization Specialist located in The Woodlands, Texasyou play an important role in the overall success of the company. Working with our billing tool provider, & partnering with colleagues in Finance & Client Services, you will drive payment by contacting insurance companies to secure preauthorization required for patients to receive our services. You will ensure information obtained is complete & accurate, follow up on requests, & apply acquired knowledge of Medicare, Medicaid, & other Third-Party Payer requirements & online eligibility/preauthorization systems. You will facilitate optimized billing processes & operations that are aligned with Guardant Health's mission & values.
You will help develop & maintain a database of payer authorization requirements, & manage documentation for appropriate payer communication, correspondence, & insurance claim research. You're responsible for tracking, reporting & addressing complex outstanding claims. You will work to troubleshoot EOBs, appeal non-covered & inappropriately adjudicated claims, follow-up on claims, & drive positive coverage determinations through external appeals.
You are interested in being on the ground floor of a dynamic, fast paced organization. You are organized, have strong attention to detail, & are a self-starter who can work with minimal supervision. Tech savvy & analytical, you enjoy unpacking & resolving complex issues. Customer service is in your DNA, & you are known for your ability to communicate effectively through even the most tangled scenarios.
Your background includes three years of work experience in a healthcare environment focused on healthcare reimbursement, including knowledge of health plan regulations & processes. Your previous experience in similar roles enables you to hit the ground running & contribute insights & solutions to your team.
You should have moderate Excel skills, like the ability to sort, filter & perform simple calculations. You have experience working with a broad range of payers & have experience coordinating with insurance providers, physicians, & patients to obtain prior authorizations. You have also appealed to state level agencies or external level review with IRO/IRBs.
Familiarity with laboratory billing, Xifin, EDI enrollment, merchant solutions, payer portals & national as well as regional payers throughout the country are a plus.
Employee may be required to lift routine office supplies up to 25 lbs & use office equipment. Majority of the work is performed in a desk/office environment; however, there may be exposure to high noise levels, fumes, & biohazard material in the laboratory environment. Ability to sit for extended periods of time.
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 & will not be discriminated against on the basis of disability.
All your information will be kept confidential according to EEO guidelines.
Please visit our career page at:http://www.guardanthealth.com/jobs/