Job description
Headquartered in Brisbane, Calif., CareDx, Inc. is a leading precision medicine solutions company focused on the discovery, development, and commercialization of clinically differentiated, high-value healthcare solutions for transplant patients and caregivers. CareDx offers products, testing services, and digital healthcare solutions along the pre- and post-transplant patient journey, and is the leading provider of genomics-based information for transplant patients.
CareDX is hiring!! Reimbursement Specialist needed in South San Francisco, CA
Day-to-Day Responsibilities:
- Communicates with providers regarding verification of patient and insurance demographic information
- Investigates and respond to errors generated from electronic claims submissions
- Assists in researching eligibility submission problems/new client submissions
- Interfaces with other departments, external providers, or clients, as may be required, to resolve errors
- Verifies patient information using links to hospitals and web-based sites
- Provides backup support in all areas of the Front End Department
- Coordinates activities with other team members to insure timely distribution of work to outside locations
- Remains knowledgeable and current on third-party requirements, and regulatory guidelines at the federal, state, and local levels
- Participates in administrative staff meetings and attends other meetings and seminars
- Assist in the evaluation of reports, decisions, and results of the department in relation to established goals
- Recommends new approaches, policies, and procedures to effect continual improvements in the efficiency of department and services performed
- Serves as a member of the Front End Team. Performs duties necessary to ensure the team's projects/goals are completed
- Takes ownership of special projects, researches data, and follows through with detailed action plans
- Actively participates in problem identification and resolution and coordinates resolutions between appropriate parties
- Performs other related duties as required and assigned
- Obtain referrals and pre-authorizations as required for procedures
- Check eligibility and benefit verification
- Prepare, review, and transmit claims using billing software, including electronic and paper claim processing
- Knowledge of insurance guidelines, including HMO/PPO, Medicare, and state Medicaid
- Identify and bill secondary or tertiary insurances
Qualifications:
- License/Certification/Education: Requires a High School Diploma or equivalent
- Working Knowledge of denials, adjustments, and Third Party Operations and/or Analysis
- Strong analytical skills and ability to manipulate data in Microsoft Excel
- Ability to work independently with minimal supervision
- Must be able to analyze, summarize and provide detail of findings when needed
- Ability to problem-solve an issue to determine the root cause
Duties include working billing queues as part of a team. This position promotes the efficient processing of claims and claims productivity by verifying and entering patients’ demographic and insurance information into the Telcor billing system; obtaining accurate identification numbers and eligibility information from insurance carriers via the Internet and/or phone; investigates errors generated from electronic claims submission.
Additional Details:
Every individual at CareDx has a direct impact on our collective mission to improve the lives of organ transplant patients worldwide. We believe in taking great care of our people, so they take even greater care of our patients.
Our competitive Total Rewards package includes:
- Competitive base salary and incentive compensation
- Health and welfare benefits including a gym reimbursement program
- 401(k) savings plan match
- Employee Stock Purchase Plan
- Pre-tax commuter benefits
- And more!
In addition, we have a Living Donor Employee Recovery Policy that allows up to 30 days of paid leave annually to a full-time employee who makes the selfless act 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 future, it’s an exciting time to be part of the CareDx team. Join us in partnering with transplant patients to transform our future together.
CareDx, Inc. is an Equal Opportunity Employer and participates in the E-Verify program.
- 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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