Full-Time Reimbursement Specialist II - Prior Authorization
Guardant Health is hiring a remote Full-Time Reimbursement Specialist II - Prior Authorization. The career level for this job opening is Experienced and is accepting US based applicants remotely. Read complete job description before applying.
This job was posted 3 months ago and is likely no
longer active. We encourage you to explore more recent opportunities on our site. However, you
may still try your luck using 'Apply Now' link below. We recommend focusing on newer listings
available here.
Guardant Health
Job Title
Reimbursement Specialist II - Prior Authorization
Posted
Career Level
Full-Time
Career Level
Experienced
Locations Accepted
US
Salary
HOUR $22 - $30
Share
Job Details
About the Role:
As a Reimbursement and Prior Authorization Specialist II, 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.
As a Reimbursement and Prior Authorization Specialist II, 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 all documentation related to payer communication, correspondence, and insurance claims research.
- Track, report, and resolve complex claims, ensuring prompt 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 via appeals and external review organizations.
- Ensure compliance with Medicare, Medicaid, and other third-party payer requirements and online eligibility/preauthorization systems.
- Support continuous improvement of billing and authorization processes aligning with company values.
Qualifications:
- 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 Excel (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 plus
Skills
FAQs
What is the last date for applying to the job?
The deadline to apply for Full-Time Reimbursement Specialist II - Prior Authorization at Guardant Health is
4th of October 2025
. We consider jobs older than one month to have expired.
Which countries are accepted for this remote job?
This job accepts [
US
] applicants. .
Related Jobs You May Like
HB Coding Analyst (Remote - IL, IN, IA, or WI)
IL, IN, IA, or WI
1 day ago
Claim Denials
CPT-4 Coding
Data Analysis
Northwestern Memorial Healthcare
Full-Time
Experienced
Insurance Credit Resolution Specialist
Remote, USA
3 days ago
AHCCCS
AthenaHealth
HIPAA
Privia Health
Full-Time
Experienced
HOUR $25 - $26
Medical Claims Billing Specialist
Remote, USA
4 days ago
Accounts Receivable
Athena EHR
Claim Resolution
Privia Health
Full-Time
Experienced
HOUR $24 - $26
Senior Clinical Coding Auditor & Trainer (Remote)
New York, NY
1 week ago
Auditing
Clinical Coding
CPT
CRD Careers (Independent Recruiters)
Full-Time
Experienced
Medical Claims Billing Specialist
Remote, USA
1 week ago
Accounts Receivable
Athena EHR
Denial Management
Privia Health
Full-Time
Experienced
HOUR $24 - $26
Insurance Credit Resolution Specialist
Remote, USA
1 week ago
AthenaHealth
Claims Management
HIPAA Compliance
Privia Health
Full-Time
Experienced
HOUR $25 - $26
Care Center Biller (CPC Preferred)
Remote, USA
2 weeks ago
Charge Entry
Coding
Communication
Privia Health
Full-Time
Experienced
HOUR $21 - $24
Manager, Revenue Integrity
Remote, USA
2 weeks ago
Auditing
Contract Negotiation
Data Analysis
Privia Health
Full-Time
Manager
YEAR $75000 - $88000
Assistant Manager of Billing
USA
2 weeks ago
Accounting
Billing Operations
Client Communication
Crowell & Moring
Full-Time
Manager
YEAR $96000 - $146000
Remote Medical Biller (Dental Claims)
Worldwide
2 weeks ago
Data Entry
Dental Billing
HIPAA Compliance
RemoteVA
Full-Time
Experienced
Medical Claims Billing Specialist
Remote, USA
2 weeks ago
Accounts Receivable
Athena EHR
Denial Management
Privia Health
Full-Time
Experienced
HOUR $24 - $26
Medical Claims Billing Specialist
Remote, USA
3 weeks ago
Accounts Receivable
Athena EHR
Data Analysis
Privia Health
Full-Time
Experienced
HOUR $24 - $26