Guardant Health · 1 day ago
Reimbursement Prior Authorization Specialist II
Palo Alto, CA
Full-time
Hybrid
Mid Level
$23/hr - $37/hr
3+ years expGuardant Health is a leading precision oncology company focused on guarding wellness and giving every person more time free from cancer. As a Reimbursement Specialist II – Prior Authorization, you will manage the full prior authorization lifecycle, ensuring patients receive timely access to care while maximizing reimbursement outcomes for the organization.
BiotechnologyHealth CareHealth DiagnosticsOncologyTherapeutics
Responsibilities
Manage the full prior authorization lifecycle, including navigating complex payer policies and securing timely approvals
Actively review, submit, track and resolve Prior Authorization inquiries using appropriate systems and tools (SalesForce/Telcor/Emails/Fax/Phone/Portals) until final approval is obtained
Resolve escalated rejected authorizations issues and streamline processes for efficiency
Research system notes to obtain missing or corrected insurance or demographic information
Prepare and submit necessary medical records, documentation, and justification to insurance companies
Ensure all required documentation is complete and accurate to avoid delays in authorization
Manage faxes, emails, phone calls and respond to voicemails and emails
Maintain comprehensive documentation of payer requirements and support process improvement initiatives
Follow appropriate HIPAA guidelines
Performs other added responsibilities as assigned to support the overall efficiency of the department
Communicate effectively with cross-functional teams and ordering physician offices to identify and address inefficiencies impacting ASP and claims adjudication processes
Work closely with staff to investigate and resolve delays, rejections, or discrepancies related to claims submissions for optimal reimbursement
Qualification
Required
Minimum of 3+ years of healthcare reimbursement experience, with a strong focus on prior authorization, insurance coordination, payer relations and appeals
Expert-level knowledge of Medicare, Medicaid, IPA and commercial payer authorization policies and appeals processes
Demonstrated success in managing complex, high-priority claims, including overturning denials through advanced appeal strategies and external reviews
Proficiency with revenue cycle tools and systems such as Xifin/Telcor, payer portals, and Salesforce
Proven track record of working cross-functionally with internal teams and external stakeholders to resolve reimbursement challenges
Exceptional attention to detail, self-motivated, organizational abilities and driven to identify process improvements that enhance operational performance
Demonstrated proficiency with using a computer hardware and PC software, specifically Microsoft Office Suite, Adobe Acrobat PDF, particularly Excel, and have above average typing skills
Experience with contacting and follow up with insurance carriers
Analytical mindset with experience in data analysis and process optimization
Ability to work independently and handle confidential and sensitive information with utmost discretion
Must be able to work cohesively in a team-oriented environment and be able to foster good working relationships with others both within and outside the organization
Excellent communication and interpersonal skills to facilitate collaboration across department, with an ability to distill complex issues for both technical and non-technical audiences
Preferred
Experience with laboratory billing workflows and national/regional payer requirements is highly desirable
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