Insurance Reimbursement Specialist

CareDx; San Francisco (CA); Hybrid; USD 39,000 - 50,000; Full time

Benefits offered by this job

Health and welfare benefits

Gym reimbursement

Living Donor Employee Recovery Policy

Paid organ donation leave

Job summary

CareDx, a leader in precision medicine diagnostics, is seeking an Insurance Reimbursement Specialist to maximize collections by pursuing unpaid claims and managing multi-level appeals. This full-time role is based in Brisbane, CA, with some remote collaboration for eligible candidates.

You will work with payer portals, coordinate with the Revenue Cycle team, and support denial management while maintaining HIPAA guidelines and patient privacy.

Qualifications

• Education: High school diploma or equivalent.
• Experience: 3-5 years in medical billing; molecular lab billing experience preferred; bachelor’s degree may substitute.
• Understanding of HIPAA and PHI handling.
• Working knowledge of health insurance terminology.

Responsibilities

• Resolve aged claims and appeals via payer portals and outbound calls.
• Identify claims needing first/second/third level appeals.
• Assist teammates with projects and denial work queue management.

Skills

Medical billing

HIPAA knowledge

Communication skills

Analytical skills

Problem solving

Education

High school diploma or equivalent

Job description

CareDx is a leading precision medicine diagnostics company advancing care in transplant, specialty oncology, and cell therapy. Through our innovative portfolio of molecular diagnostics, digital health solutions, AI-powered data and analytics, and patient support services, we partner with healthcare providers, patients, and biopharma organizations to help inform clinical decision-making and improve patient outcomes.

At CareDx, every employee has the opportunity to contribute to innovations that help transform patient care and improve lives.

Ideal candidate will be within commutable driving distance to Brisbane, CA

The primary responsibility of the Insurance Reimbursement Specialist is to maximize reimbursement by collecting outstanding balances from insurance companies. The Specialist will maximize collections by following up on unresolved claims and appeals, and by escalating claims for reconsiderations and up to three levels of appeals. The Specialist will work closely with the CareDx Payer Dispute Resolution and Market Access teams to ensure CareDx receives coverage and appropriate reimbursement from contracted and non-contracted payers and government health plans.

This role requires meticulous work and the ability to thrive in a fast‑paced environment. This is a full‑time position, Monday through Friday, with occasional overtime as needed. Candidates within commuting distance of the Brisbane, California office will need to come to the office on a regular basis; remote candidates will work and collaborate from home.

Responsibilities

• Resolve aged claims and appeals without payer responses via payer portals & outbound phone calls.
• Identify claims that need a first, second, or third level appeal.
• Assist teammates with projects and denial work queue management.

Denials and appeals

• Prioritize an assigned work queue to ensure timely work is balanced with working the most payable claims.
• Identify non-payment trends and, in collaboration with Revenue Cycle leadership, escalate groups of claims to the CareDx Payer Dispute Resolution or Market Access teams.
• Investigate denial and non-payment trends identified by the Revenue Cycle Analytics team. Propose solutions and collaborate cross-functionally with the Denials Management Steering Committee.
• Share opportunities to improve upstream work to prevent denials.
• Work with patients when their assistance is needed in the appeal process.
• Work professionally with Revenue Cycle teammates to be responsive to requests that require your assistance.

Qualifications

• Education: High school diploma or equivalent.
• Experience: 3-5 years’ experience in medical billing; strong preference will be given to candidates with molecular laboratory billing experience. Medical billing experience may be substituted with a bachelor’s degree.
• Understanding of patient protections under HIPAA and proper handling of protected health information (PHI).
• Working knowledge of health insurance and terminology.
• Excellent communication and people skills.
• Meticulous with strong analytical and problem-solving abilities.

Every individual at CareDx has a direct impact on our collective mission to improve the lives of organ transplant patients worldwide. We believe in taking great care of our people, so they take even greater care of our patients.

Our Competitive Total Rewards package for US Employees includes:

• Competitive base salary and incentive compensation
• Health and welfare benefits, including a gym reimbursement program

In addition, we have a Living Donor Employee Recovery Policy that allows up to 30 days of paid leave annually to a full-time employee who makes the self‑less act of donating an organ or bone marrow.

With products that are making a difference in the lives of transplant patients today and a promising pipeline for the future, it’s an exciting time to be part of the CareDx team. Join us in partnering with transplant patients to transform our future together.

CareDx, Inc. is an Equal Opportunity Employer‑vets/disabled, and participates in the E-Verify program.

This is the anticipated base salary range for candidates who will work in Brisbane, California.

$28 - $36 USD

This is the anticipated base salary range in the United States.

$24 - $30 USD

Remote: US only roles