Reimbursement Specialist - Order Entry

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

As a Reimbursement Specialist, Order Entry, 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 incoming demographics entry into the billing tool and clean claims submissions using a HCFA 1500 claims form or electronic equivalent. Incoming demographics information will be transferred from LIMS/LIS portal to the billing tool and checked for

eligibility prior to claim submission. Troubleshooting front-end denials of electronic claims using payer portals will ensure that tests are billed in a timely manner to payers.

Essential Duties and Responsibilities:

• Processing a high volume of 500+ patients demographics entries into the billing tool daily.
• Accurate data entry of information into computer systems including notating accounts accurately to ensure the best patient experience.
• Quality control of daily entries into the billing tool through cross-referencing internal intelligence to ensure the highest level of accuracy.
• Creation and set up of insurance plan types in the Xifin billing platform for clean claim submission using a HCFA 1500 claim form or the electronic equivalent.
• Follow appropriate HIPAA guidelines to use electronic payor portals to verify patient insurance eligibility.
• Follow appropriate HIPAA guidelines to translate patient insurance information into the billing tool and communicate patient insurance information with insurance providers.
• Accurate identification and assignment of billing codes to patient orders to generate anticipated price markers.
• Work well individually and in a team environment accomplishing set goals.
• Performs other related duties as assigned.

Qualifications

A minimum of 1-year recent experience in both professional and facility billing, and collections with high volume and/or multiple accounts

• Accurate identification …