Reimbursement Specialist
Core
Manage the insurance billing life cycle to ensure accurate and timely reimbursement for Veracyte's cancer diagnostic tests.
Role type
mid-level reimbursement specialist
Builds
insurance claim submissions, payment postings, and appeals for cancer diagnostics
Domain
healthcare diagnostics + medical billing
Required skills
medical billing, insurance claims processing, revenue cycle operations, payer portal navigation, HIPAA compliance, CRM usage, billing software proficiency, data entry, Excel, ICD/HCPCS/CPT coding, CMS 1500 claim forms, Claim Adjustment Reason Codes
Preferred skills
healthcare administration degree, analytical skills, interpersonal skills, organizational skills, time management, entrepreneurial spirit
Technologies
Salesforce, Epic, XiFin, Quadax, Microsoft Office (Word, Excel)
Responsibilities
Research and monitor billing issues, trends, and risks; review and ensure accurate claim submissions; track claim status and generate reports; review denied/unpaid claims and take corrective action (resubmission, appeals); assist patients with financial navigation; verify insurance/recipient benefits with Medicare, Medicaid, and private payers; navigate payor portals for eligibility and prior auth; review and interpret explanation of benefits.
Seniority
Mid-level, hands-on IC