Reimbursement Specialist

At Veracyte, we offer exciting career opportunities for those interested in joining a pioneering team that is committed to transforming cancer care for patients across the globe. Working at Veracyte – whether it be in one of our labs, corporate offices, the field – enables our employees to not only make a meaningful impact on the lives of patients, but to also learn and grow within a results-driven environment that values innovation, collaboration, and compassion.

The Position

The successful candidate will be a rockstar at identifying, analyzing, and resolving insurance company denials. While working with our Reimbursement, Commercial, and Finance teams this role will provide on-going insight and analytics on all medical insurance claims. This position is remote, ideally in the Mountain or Pacific time zone, and the hours will be 8:30am - 5:00pm Pacific time.

Responsibilities Include

• Verifying insurance/recipient eligibility, billing and follow-up on claims to Medicare, Medicaid and Private Insurer Payers.
• Researching and responding to Medicare, Medicaid and other Payer inquiries regarding billing issues and insurance updates.
• Reviewing unpaid and/or denied claims, appeals and follow-up on accounts to zero status.
• Organizing and distribute comprehensive appeal packages to the insurance provider.
• Ability to review and interpret explanation of benefits to determine contractual allowance.
• Researching accounts and resolving deficiencies.
• Calling insurance companies regarding outstanding accounts. Utilize payor websites to check claim status.
• Reviewing and submitting accurate claims, re-submissions and claim review forms.
• Researching and monitoring specific billing issues, trends and potential risks based on current research and customer feedback.
• Answering all patient/doctor/hospital/lab/insurance company phone calls regarding accounts, and takes appropriate action.
• Providing administrative support (when requested) including performing data entry, updating various record keeping systems, upholding company policies and Client requirements, and participating in projects, duties, and other administrative tasks.
• Knowledge, understanding, and compliance with all applicable Federal and Local laws and regulations relating to job duties.
• Knowledge, understanding, and compliance with Company policies and procedures.
• Other duties as assigned.
  
  

Who You Are

• A university degree or a Certified Professional Coder or 2 yr Degree from Accredited Medical Billing School
• 3-5 Years of direct appeals and billing experience
• Experience with XiFin and Salesforce desired, but not required
• Experience working with protected health information (PHI), requiring a high level of privacy, confidentiality and a private work space
• Enthusiasm and an entrepreneurial spirit
• Familiarity with ICD and HCPC/CPT coding preferred
• Familiarity with CMS 1500 claim form preferred
• Familiarity with Claim Adjustment Reason Codes (NUCC) preferred
• Use of personal computer, computer applications, and general office equipment including scanners.
• Ability to create and maintain spreadsheets
• Ability to use analytical, interpersonal, communication, organizational, numerical, and time management skills.
• Experience handling and expediting escalated issues, with follow up to the customer.
• Ability to quickly assess a situation and take appropriate actions to address customer needs and requests in a timely and efficient manner. Self-starter with the ability to work independently and effectively in a team environment.
• Ability to organize and prioritize multiple projects/tasks and meet deadlines in a constantly evolving and fast-paced environment.
• Strong, consistent work ethic with a keen attention to details and ability to focus on the big picture.
• Excellent written and verbal communication skills.
• Must be able to communicate with confidence and tact across all levels within the company.
  
  

The final salary offered to a successful candidate will be dependent on several factors that may include but are not limited to the type and length of experience within the job, type and length of experience within the industry, education, etc. Base pay is one part of the Total Package that is provided to compensate and recognize employees for their work, and this role may be eligible for additional discretionary bonuses/incentives, and restricted stock units. Veracyte is a multi-state employer, and this salary range may not reflect positions that work in other states.

Pay range

$23—$25 USD

What We Can Offer You

Veracyte is a growing company that offers significant career opportunities if you are curious, driven, patient-oriented and aspire to help us build a great company. We offer competitive compensation and benefits, and are committed to fostering an inclusive workforce, where diverse backgrounds are represented, engaged, and empowered to drive innovative ideas and decisions. We are proud to have been named a “Bay Area Top Workplace” for 11 years in a row by the Bay Area News Group and “Best Places to Work in San Diego” in 2023 by the San Diego Business Journal.

About Veracyte

Veracyte (Nasdaq: VCYT) is a global genomic diagnostics company that improves patient care by providing answers to clinical questions, informing diagnosis and treatment decisions throughout the patient journey in cancer and other diseases. The company’s growing menu of genomic tests leverage advances in genomic science and technology, enabling patients to avoid risky, costly diagnostic procedures and quicken time to appropriate treatment. The company’s tests in lung cancer, prostate cancer, breast cancer, thyroid cancer, bladder cancer and idiopathic pulmonary fibrosis are available to patients and its lymphoma subtyping and renal cancer tests are in development. With Veracyte’s exclusive global license to a best-in-class diagnostics instrument platform, the company is positioned to deliver its tests to patients worldwide. Veracyte is based in South San Francisco, California. For more information, please visit www.veracyte.com and follow the company on X (Formerly Twitter).

Veracyte, Inc. is an Equal Opportunity Employer and will consider all qualified applicants for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status or disability status. Veracyte participates in E-Verify in the United States. View our CCPA Disclosure Notice.

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