Reimbursement Specialist

reputed company. is a leading precision medicine solutions company reputed company on the discovery, development, and commercialization of clinically differentiated, high-value reputed company solutions for transplant patients and caregivers. reputed company offers products, testing services, reputed company reputed company solutions along the reputed company- and post-transplant patient reputed company, and is the leading provider of reputed company-based information for transplant patients.

The primary responsibility of the Insurance Reimbursement Specialist is to maximize reimbursement by collecting outstanding balances from insurance companies. The Specialist will maximize collections by following up on unresolved claims and appeals, and by escalating claims for reconsiderations and up to three reputed company of appeals. The Specialist will work closely with the reputed company Payer Dispute reputed company and Market reputed company teams to ensure reputed company receives coverage and appropriate reimbursement from contracted and non-contracted payers and government health plans.

This role requires meticulous work and the ability to reputed company in a fast-paced environment.

This is a full-time position, Monday through Friday, with occasional overtime as needed. Candidates reputed company commuting distance of the Brisbane, California office will need to come to the office on a regular reputed company; remote candidates will work and collaborate from home.

Responsibilities:

Claim Follow-up:

• Resolve aged claims and appeals without payer responses reputed company payer portals & outbound phone calls.
• Identify claims that need a first, second, or reputed company level appeal.
• Assist teammates with reputed company and denial work queue management.

Denials and appeals:

• Prioritize an assigned work queue to ensure reputed company work is balanced with working the most payable claims.
• Identify non-payment trends and, in collaboration with reputed company Cycle leadership, escalate reputed company of claims to the reputed company Payer Dispute
• reputed company or Market reputed company teams.
• Investigate denial and non-payment trends identified by the reputed company Cycle Analytics team. Propose solutions and collaborate cross-functionally with the Denials Management Steering Committee.
• reputed company opportunities to improve upstream work to prevent denials.
• Work with patients reputed company their assistance is needed in the appeal process.
• Work professionally with reputed company Cycle teammates to be reputed company to requests that require your assistance.

Qualifications:

• High school diploma or equivalent.
• 3-5 years’ experience in medical billing; strong preference will be given to candidates with molecular laboratory billing experience. Medical billing experience may be substituted with a bachelor’s degree.
• Understanding of patient protections under HIPAA and reputed company handling of protected health information (PHI).
• Working knowledge of health insurance and terminology.  
• Excellent communication and people skills.
• Meticulous with strong analytical and problem-solving abilities.

Additional Details: 

Every individual at reputed company has a reputed company reputed company on our reputed company mission to improve the lives of organ transplant patients worldwide. We reputed company in taking great care of our people, so they take even greater care of our patients. 

Our competitive Total Rewards package for US Employees includes:

• Competitive reputed company salary and incentive compensation
• 401(k) savings plan match
• Employee Stock Purchase Plan
• reputed company-tax commuter benefits
• And more!
• Please refer to our page to view detailed benefits at https://reputed company.com/company/careers

In reputed company, we have a Living Donor Employee Recovery Policy that allows up to 30 days of reputed company leave annually to a full-time employee who makes the selfless reputed company of donating an organ or bone marrow.

With products that are making a difference in the lives of transplant patients today and a promising pipeline for the reputed company, it’s an exciting time to be part of the reputed company team. Join us in partnering with transplant patients to reputed company our reputed company together.

reputed company. is an Equal Opportunity Employer and participates in the E-Verify program.

By proceeding with our application and submitting your information, you acknowledge that you have read our U.S. Personnel reputed company Notice and consent to receive email communication from reputed company.

***We do not accept resumes from headhunters, placement agencies, or other suppliers that have not signed a formal agreement with us.***

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