Guardant Health
Reimbursement Specialist II
RemoteUnited States only
- Role
- Operations
- Experience
- Mid
- Employment
- Full-time
- Company size
- Enterprise
$24–$33/hr
Check eligibility
Open to US only. Set where you work from to check your eligibility.
No BS summary
Mid-level healthcare reimbursement specialist with 2+ years' experience. Must handle claim follow-ups, complex appeals (state and external reviews), payer communications, and work PST hours. Remote within USA (CA pay band shown); hybrid onsite requirement if within 50 miles of a Guardant facility.
Core skills
appeals
Required skills
payer portalsEDI enrollmentExcel
Optional skills
Xifinlaboratory billingmerchant solutionsnational/regional payers
What you'll do
- Track, report, and resolve complex outstanding claims.
- Troubleshoot Explanation of Benefits (EOBs) and identify reasons for claim denials or low payments.
- Appeal non-covered or underpaid claims through external review channels.
- Follow up on unpaid claims to ensure timely resolution.
- Drive positive coverage determinations through external appeals.
- Maintain accurate documentation of payer communications, correspondence, and insurance research.
What they require
- 2+ years’ experience in a healthcare reimbursement role
- Solid understanding of health plan regulations, billing processes, and payer interactions.
- Experience with appeals at state and external review levels (IRO/IRBs) is preferred.
- Organized with strong attention to detail
- Self-starter capable of working independently with minimal supervision
- Tech-savvy and analytical, able to troubleshoot complex issues
- Excellent written and verbal communication skills, especially in challenging scenarios
- Moderate proficiency in Excel (sorting, filtering, basic calculations)
- Familiarity with laboratory billing, Xifin, EDI enrollment, payer portals, merchant solutions, and national/regional payers is a plus.
Benefits
- Hybrid Work Model with defined in-office days for employees living within 50 miles of a Guardant facility
- Reasonable accommodations in hiring processes for candidates with disabilities, long-term conditions, mental health conditions, or sincerely held religious beliefs
- Background screening (criminal history) required; fair consideration per applicable laws
- Equal Opportunity Employer; EEO protections
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.
$24–$33/hr