Guardant Health · 15 hours ago
Sr. Billing Compliance Analyst
United States
Full-time
Remote
Mid, Senior Level
$79K/yr - $109K/yr
5+ years expGuardant Health is a leading precision oncology company focused on guarding wellness and giving every person more time free from cancer. The Billing Compliance Analyst will ensure accurate and ethical billing practices for oncology diagnostic testing services, conducting audits and evaluating billing operations for compliance with regulations. This role is crucial in maintaining the integrity of the laboratory’s revenue cycle and supporting clean claim submission.
BiotechnologyHealth CareHealth DiagnosticsOncologyTherapeutics
Responsibilities
Perform routine and targeted audits of claims, charge capture, coding, and reimbursement activities for molecular/NGS testing
Validate that CPT/HCPCS codes, modifiers, units, and diagnosis codes are accurate and supported by documentation
Monitor compliance with Medicare, Medicaid, commercial payer policies, NCCI edits, and LCD/NCD requirements specific to molecular pathology and oncology testing
Identify root causes of billing errors, patterns of non-compliance, and potential areas of financial or regulatory risk
Review laboratory reports, requisitions, clinical documentation, and test orders to ensure compliance with billing rules and medical necessity criteria
Confirm alignment of billed services with laboratory workflows, reporting practices, and test menus (e.g., single-gene assays, NGS panels, somatic variant analysis)
Maintain up-to-date knowledge of relevant regulations (CLIA, CMS, OIG guidance, HIPAA, PAMA, applicable state laws)
Provide actionable feedback and training to billing, revenue cycle, and client services regarding audit findings
Collaborate with billing leadership to revise SOPs, coding guidelines, and internal controls to prevent errors
Support readiness for internal and external audits, including payer audits, RAC audits, and accreditation reviews
Prepare detailed audit reports summarizing findings, corrective actions, and compliance risks
Track audit metrics, trends, and key performance indicators to support continuous improvement
Escalate high-risk issues to leadership and assist in developing corrective action plans
Qualification
Required
Bachelor's degree in Healthcare Administration, Medical Billing, Health Information Management, or related field; or equivalent experience
5+ years of experience in medical billing, revenue cycle, or compliance auditing preferably in a molecular diagnostics or pathology environment
Knowledge of CPT, HCPCS, ICD-10, and payer reimbursement policies for laboratory services
Experience interpreting Medicare LCDs/NCDs, particularly for molecular/NGS testing
Strong analytical, investigative, and documentation skills
Ability to work with sensitive information while maintaining confidentiality
Preferred
Experience with oncology/laboratory coding, molecular pathology guidelines, and genetic testing policies
Familiarity with reimbursement systems, LIMS, EMR/EHR integrations, and clearinghouses
Understanding of OIG work plans and compliance frameworks in laboratory settings
Certification(s): CPC, CPMA, CCA, CCS, CHC, or equivalent
Company
Guardant Health
Guardant Health is a precision oncology company that uses blood tests, data sets, and analytics to provide treatment to cancer patients.
1001-5000 employees
H1B Sponsorship
Guardant Health has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (38)
2024 (50)
2023 (40)
2022 (72)
2021 (57)
2020 (29)
Funding
Current Stage
Public CompanyTotal Funding
$2.53BKey Investors
Baillie GiffordSoftBank Vision FundOrbiMed
2025-11-05Post Ipo Equity· $284.4M
2025-11-05Post Ipo Debt· $350M
2023-12-21Post Ipo Equity· $90.7M
Leadership Team
AmirAli Talasaz
Co-founder and Co-Chief Executive Officer
Helmy Eltoukhy
Chairman and Co-Chief Executive Officer
Recent News
2026-01-23
Company data provided by crunchbase