Full-Time Supervisor, Reimbursement - Follow Up & Appeals

About the Role: As a Supervisor, you play an important role in team oversight. Drive improvements in ASP and revenue cycle performance. Requires strong data analysis, process optimization, and cross-functional coordination. Maintain high standards in claim adjudication and foster continuous quality enhancement. Optimize billing processes aligned with Guardant Health's mission. Facilitate efficiency improvements: Claims and Appeal Follow-up, EDI/ERA/EFT enrollments, lockbox improvements, eligibility validations, and provider payer portal registration. Manage day-to-day activities, providing guidance for accurate and timely documentation for member claims/appeals. Knowledge of, and ability to perform, staff duties. Strong communication and troubleshooting skills essential.

Essential Duties and Responsibilities:

• Serve as subject matter expert on compliance processes, regulations, and issues, providing guidance and clarity.
• Collaborate with Revenue Cycle Manager Leadership to audit claims and collections, ensuring accuracy and maximizing cash flow.
• Maximize cash collections through monitoring open accounts receivable balances.
• Analyze reimbursement data, review carrier exception reports, and follow up on pending claims and denials, presenting findings and developing action plans.
• Prepare reports on billing activities, accounts receivable metrics, bad debt expenses, and days outstanding for process improvements.
• Conduct audits of billing records to verify data accuracy and completeness.
• Assist in developing and maintaining department SOPs aligned with CLSI guidelines.
• Evaluate KPIs, provide performance feedback, and support staff development and coaching for accurate documentation and timely claim submissions.
• Facilitate onboarding, training, and updates to training materials, workflows, and change management strategies.
• Follow HIPAA and other regulatory guidelines.
• Perform other related duties as assigned.

Requirements:

• High school diploma or equivalent. Business, healthcare administration, or related major preferred. Relevant experience may substitute for degree.
• 3+ years healthcare revenue cycle management experience, 1+ year in a leadership role.
• Excellent leadership and team management skills, attention to detail, and accuracy.
• Knowledge of medical terminology, CPT, and ICD coding. Managed care requirements for reimbursement preferred.
• Experience with contacting and following up with insurance carriers, file reconsideration requests, formal appeals, and negotiations (preferred).
• Proficient with computers, PC software, especially Microsoft Office Suite (Excel). Above-average typing skills.
• Excellent communication skills (written and verbal).
• Familiarity with laboratory billing, Xifin, Telcor, payer portals and national/regional payers (a plus).
• Ability to incorporate mission and core values into processes and workflows.
• Effective interpersonal skills for team work and collaboration.

Salary: $83,220 - $114,480 (Palo Alto/Redwood City: $97,900 - $134,650)

Work Model: Hybrid, with defined in-person/onsite days.

Additional Info: Employee may be required to lift routine office supplies and use office equipment. Majority of work is in a desk/office environment, with potential exposure to high noise, fumes, and biohazard material. Ability to sit for extended periods.

Equal Opportunity Employer

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