[Hiring] Reimbursement Specialist II REMOTE USA
Position: Reimbursement Specialist II
Date Posted: October 22, 2025
Industry: Healthcare / Precision Oncology / Revenue Cycle Management
Employment Type: Full Time
Experience: 3+ years of healthcare reimbursement experience
Qualification: Estimated Qualification like Bachelor Degree holder, Diploma/Degree/Certificate
Salary: $22 – $31/hour
Location: Remote – Open Position, United States, REMOTE
Company: Guardant Health
Description:
We’re Hiring: Reimbursement Specialist II
Guardant Health is a leading precision oncology company dedicated to advancing patient care and extending lives free from cancer. Founded in 2012, Guardant Health provides cutting-edge blood and tissue tests, real-world data, and AI analytics to improve outcomes across all stages of cancer care—from early screening and monitoring to advanced treatment selection.
Shift: 9:00 AM – 6:00 PM PST, Monday – Friday
About the Role:
As a Reimbursement Specialist II – Prior Authorization, you will be a key contributor to the revenue cycle team, applying deep knowledge of payer policies, prior authorization, and insurance processes to ensure timely patient access to care and optimize reimbursement outcomes. You will independently manage the full prior authorization lifecycle, resolve escalated issues, and collaborate with physician offices and internal teams to maintain a seamless workflow.
Key Responsibilities:
Revenue Cycle Management
✔ Manage the entire prior authorization process, navigating complex payer policies and securing timely approvals.
✔ Review, submit, track, and resolve prior authorization inquiries using Salesforce, Telcor, email, fax, phone, and portals.
✔ Troubleshoot rejected authorizations and streamline processes for efficiency.
✔ Research system notes to obtain missing or corrected insurance or demographic information.
✔ Prepare and submit required medical records and documentation to insurance companies.
✔ Ensure all documentation is complete and accurate to prevent delays.
✔ Respond to emails, voicemails, faxes, and phone calls in a timely manner.
✔ Maintain comprehensive payer documentation and support process improvement initiatives.
✔ Adhere to HIPAA guidelines and demonstrate company Leadership Attributes in all duties.
Cross-Functional Collaboration
✔ Communicate effectively with internal teams and physician offices to resolve reimbursement inefficiencies.
✔ Investigate and resolve delays, rejections, or discrepancies related to claims submissions.
Travel Requirements
✔ Participate in corporate events, development opportunities, and conferences.
✔ Engage in team-building activities and collaborate with cross-functional teams.
Qualifications
✔ Minimum of 3+ years in healthcare reimbursement, focusing on prior authorization, insurance coordination, payer relations, and appeals.
✔ Expert knowledge of Medicare, Medicaid, IPA, and commercial payer authorization policies.
✔ Proven ability to manage complex claims, including overturning denials via appeals and external reviews.
✔ Proficiency with revenue cycle tools like Xifin, Telcor, payer portals, and Salesforce.
✔ Experience with laboratory billing workflows and national/regional payer requirements preferred.
✔ Strong analytical skills and experience in process optimization.
✔ Proficient in Microsoft Office Suite, Adobe Acrobat PDF, and capable of above-average typing.
✔ Excellent communication and interpersonal skills, able to collaborate across teams.
✔ Ability to handle confidential and sensitive information professionally.
✔ Team-oriented mindset with a commitment to operational excellence.
Hybrid Work Model
Employees within 50 miles of a Guardant facility may be required onsite Mondays, Tuesdays, and Thursdays. The hybrid model balances focused work-from-home time with in-person collaboration.
Additional Information
✔ Background screening required; Guardant Health provides accommodations for candidates with disabilities, long-term conditions, mental health conditions, or sincerely held religious beliefs.
✔ Guardant Health is an Equal Opportunity Employer, ensuring fair consideration without discrimination based on race, color, religion, sex, sexual orientation, gender identity, national origin, veteran status, or disability.
Disclaimer: The job details above are structured for clarity and based on publicly available content from recruiters/Company pages. All rights remain with the original source; names may be withheld for confidentiality. We are not involved in the hiring process.
