200+ applicants

Company

Veracyte, Inc. · 1 day ago

Reimbursement Specialist - West Coast

United States

Full-time

Remote

Entry Level

$18/hr - $22/hr

1+ years exp

Maximize your interview chances

BiotechnologyHealth Care

Insider Connection @Veracyte, Inc.

Discover valuable connections within the company who might provide insights and potential referrals.
Get 3x more responses when you reach out via email instead of LinkedIn.

Responsibilities

Processing of prior authorization cases via Glidian, eviCore and direct health plan portals

Knowledge in insurance payor authorization guidelines, and follow-up of authorization status from health plan.

Researching and responding to heavy authorization caseload in a timely manner.

Reviewing and provide an analysis of prior authorization determination denials and approvals.

Organize and maintain comprehensive files that include health plan prior authorization turnaround time, appeal guidelines and other pertinent information.

Review medical records and respond to health plan clinical questions.

Researching and monitoring of health plan issues, trends and potential risks and provide feedback to managers.

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.

Qualification

Find out how your skills align with this job's requirements. If anything seems off, you can easily click on the tags to select or unselect skills to reflect your actual expertise.

Prior Authorization ManagementMedical Billing ExperienceICD CodingHCPC/CPT CodingCMS 1500 Claim FormClaim Adjustment Reason CodesData EntrySpreadsheet CreationCustomer Service SkillsTime Management Skills

Required

High School diploma, Certified Professional Coder or 2-year degree from an Accredited Medical Billing School

1-3 Years of direct billing experience

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.

Preferred

Familiarity with ICD and HCPC/CPT coding

Familiarity with CMS 1500 claim form

Familiarity with Claim Adjustment Reason Codes (NUCC)

Company

Veracyte, Inc.

Veracyte is a global diagnostics company that empowers clinicians with the high-value insights they need to guide and assure patients at pivotal moments in the race to diagnose and treat cancer.

Founded in 2006

South San Francisco, California, USA

501-1,000 employees