Reimbursement Specialist (PST Time Zone)

1 week ago
Full-time
Junior
Operations
Veracyte

Veracyte

Veracyte develops innovative molecular diagnostic tests that provide clinicians with critical insights to enhance cancer diagnosis and treatment, ultimately aiming to improve patient outcomes and reduce healthcare costs.

Pharmaceuticals
251-1K
Founded 2008

Description

  • Research and monitor billing issues, trends, and potential risks.
  • Review claims to ensure they are submitted accurately with all pre-claim requirements completed.
  • Track claim status and pull reports to manage workflow, especially in Excel.
  • Review denied or unpaid claims and take corrective action such as resubmission or appeal with minimal guidance.
  • Provide administrative support including data entry, record updates, policy adherence, and project assistance when requested.
  • Navigate payer portals, websites, and phone systems to check eligibility, prior authorization, claim, and appeal status.
  • Apply payer guidelines and policies in day-to-day reimbursement decisions.
  • Assist patients with their financial journey with compassion and accuracy.
  • Verify insurance and recipient benefits with Medicare, Medicaid, and private insurers.
  • Review and interpret explanation of benefits documents.

Requirements

  • High school diploma or GED is required.
  • Associate's or bachelor's degree in healthcare administration, business, or a related field is preferred.
  • 2+ years of experience in medical billing, insurance claims, or revenue cycle operations.
  • Experience with payer portals and claim tracking systems.
  • Experience with Microsoft Office, especially Word and Excel.
  • Familiarity with HIPAA compliance and healthcare privacy regulations.
  • Experience working with CRMs such as Salesforce and billing software such as Epic, XiFin, or Quadax.
  • Familiarity with ICD and HCPCS/CPT coding is preferred.
  • Familiarity with CMS 1500 claim forms is preferred.
  • Familiarity with Claim Adjustment Reason Codes (NUCC) is preferred.

Benefits

  • Competitive base pay of $25-$30 USD per hour.
  • May be eligible for discretionary bonuses and incentives.
  • May be eligible for restricted stock units.
  • Competitive compensation and benefits package.
  • Remote work opportunity (#LI-Remote).
  • Inclusive, purpose-driven workplace with recognized Great Place to Work status.

Interested in this position?

Apply directly on the company website

Apply Now

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