Supervisor, Reimbursement - Follow Up & Appeals - Screening

Remote Full-time
About the Role: As a Supervisor, Reimbursement - Follow Up & Appeals , you play an important role in the overall success of the company and oversight to a dedicated team of Individual Contributors. This role is pivotal in driving sustainable improvements in Average Sale Price (ASP) and overall revenue cycle performance by leading, mentoring, and optimizing processes within the Department. The role requires a collaborative, proficient in data analysis, process optimization, and cross-functional coordination, committed to maintaining high standards in claim adjudication and fostering a culture of continuous quality enhancement. You will facilitate optimized billing processes and operations that are aligned with Guardant Health ’s mission and values. You are responsible for facilitating efficiency improvements such as: Claims and Appeal Follow-up, EDI/ERA/EFT enrollments, lockbox improvements, eligibility validations, and provider payer portal registration properly and timely. This includes managing day-to-day activities and provides guidance to the team to ensure accurate and timely documentation for services related to the members claim and/or appeal. You will be expected to be knowledgeable of, and be able to perform, the duties of the staff supervised. Strong communication and troubleshooting skills are required. Essential Duties and Responsibilities: Serve as the subject matter expert and primary resource for staff and stakeholders on compliance processes, regulations, and issues, providing guidance and clarity. Collaborate with Revenue Cycle Manager Leadership to proactively audit claims and collections across all third-party payers—including Medicare, managed care, commercial insurance, and patient payments—to ensure accuracy and maximize cash flow. Assure maximization of cash collections through organized, diligent and timely focused monitoring of all open accounts’ receivable balances. Analyze reimbursement data from various sources, review carrier exception reports, and follow up on pending claims and denials, presenting findings to leadership and developing action plans to mitigate risks. Prepare comprehensive reports on billing activities, accounts receivable metrics, bad debt expenses, and days outstanding to support continuous process improvements. Conduct audits of billing records to verify data accuracy and completeness, including payment posting and contractual adjustments. Assist in developing and maintaining department Standard Operating Procedures (SOPs) aligned with CLSI guidelines, ensuring staff adherence to policies and deadlines. Evaluate key performance indicators (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 to foster an efficient, compliant revenue cycle environment. Follow HIPAA and other regulatory guidelines diligently to protect patient information and ensure confidentiality. Performs other related duties as assigned to support the overall efficiency of the department High school diploma or equivalent degree from an accredited college or university in business, healthcare administration, or related major (relevant experience may be considered in lieu of degree) A minimum of 3-years of experience in both professional healthcare revenue cycle management, and at least 1 year of related experience in a leadership role reflective of the level of this position Excellent leadership and team management skills Exceptional attention to detail and accuracy Knowledge of medical terminology, CP,T and ICD coding Knowledge in managed care requirements as they relate to reimbursement, knowledge of US Commercial, Medicare, Medicaid and third-party payer reimbursement preferred Experience with contacting and follow-up with insurance carriers, file reconsideration requests, formal appeals and negotiations (preferred) Must be proficient using a computer, PC software, specifically Microsoft Office Suite, particularly Excel, and have above average typing skills Excellent communication skills, both written and verbal Familiarity with laboratory billing, Xifin, Telcor, payer portals and national as well as regional payers throughout the country is a plus Ability to effectively incorporate the mission and core values into processes and workflows Effective interpersonal skills to facilitate work in a team environment and to collaborate with a variety of professionals Hybrid Work Model : At Guardant Health , we have defined days for in-person/onsite collaboration and work-from-home days for individual-focused time. All U.S. employees who live within 50 miles of a Guardant facility will be required to be onsite on Mondays, Tuesdays, and Thursdays. We have found 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 better work-life balance while keeping teams connected to advance our science for our patients. The US base salary range for this full-time position is $83,220 to $114,480. The range does not include benefits, and if applicable, bonus, commission, or equity. The range displayed reflects the minimum and maximum target for new hire salaries across all US locations for the posted role with the exception of any locations specifically referenced below (if any). For positions based in Palo Alto, CA or Redwood City, CA, the base salary range for this full-time position is $97,900 to $134,650. The range does not include benefits, and if applicable, bonus, commission, or equity. Within the range, individual pay is determined by work location and additional factors, including, but not limited to, job-related skills, experience, and relevant education or training. If you are selected to move forward, 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. Guardant Health 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 reach out to [email protected] 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 and will not be discriminated against on the basis of disability. All your information will be kept confidential according to EEO guidelines. To learn more about the information collected when you apply for a position at Guardant Health , Inc. and how it is used, please review our Privacy Notice for Job Applicants . Please visit our career page at: Guardant 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 all 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 LinkedIn , X (Twitter) and Facebook . Originally posted on Himalayas
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