Reimbursement Specialist II

Guardant Health

Reimbursement Specialist managing claims follow-up and external appeals for Guardant Health’s precision oncology testing business. Resolving denials, underpayments, and coverage issues to improve reimbursement outcomes.

Posted 8/5/2026full-timeRemote • California • 🇺🇸 United StatesJuniorMid-Level💰 $24 - $33 per hourWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in healthcare reimbursement processes, including claims tracking, appeals management, and payer interactions, while maintaining strong organizational skills and attention to detail.

Highest-signal resume keywords

Healthcare Reimbursement ExperienceClaims Tracking and ResolutionAppeals ManagementPayer InteractionsExcel Proficiency

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Claims TrackingAppeals ManagementBilling ProcessesEOB TroubleshootingDocumentation MaintenanceInsurance ResearchAnalytical SkillsAttention to DetailIndependent WorkProblem Solving

Soft Skills

Excellent Communication SkillsOrganizational SkillsSelf-Starter

Tools & Technologies

XifinEDI EnrollmentPayer PortalsBilling Tool ProviderMerchant Solutions

Industry Keywords

Health Plan RegulationsPayer InteractionsLaboratory BillingExternal Review ChannelsNational PayersRegional Payers

About the role

Key responsibilities & impact

Track, report, and resolve complex outstanding claims
Troubleshoot Explanation of Benefits (EOBs) and identify reasons for claim denials or low payments
Appeal non-covered or underpaid claims through external review channels
Follow up on unpaid claims to ensure timely resolution
Drive positive coverage determinations through external appeals
Maintain accurate documentation of payer communications, correspondence, and insurance research
Collaborate with the billing tool provider, finance, and client services teams to streamline billing operations and optimize reimbursement processes

Requirements

What you’ll need

2+ years’ experience in a healthcare reimbursement role
Solid understanding of health plan regulations, billing processes, and payer interactions
Experience with appeals at state and external review levels (IRO/IRBs) is preferred
Organized with strong attention to detail
Self-starter capable of working independently with minimal supervision
Tech-savvy and analytical, able to troubleshoot complex issues
Excellent written and verbal communication skills, especially in challenging scenarios
Moderate proficiency in Excel (sorting, filtering, basic calculations)
Familiarity with laboratory billing, Xifin, EDI enrollment, payer portals, merchant solutions, and national/regional payers is a plus
Ability to work PST hours
Background screening including criminal history is required
Ability to sit for extended periods of time
May be required to lift routine office supplies and use office equipment

Benefits

Comp & perks

Remote work arrangement
Flexible work-life balance through work-from-home days (where applicable)
Reasonable accommodations during hiring processes
Equal Opportunity Employer
Confidential handling of applicant information