Reimbursement Specialist

Veracyte, Inc.; South San Francisco (CA); Remote; USD 34,000 - 47,000; Full time

Job summary

Veracyte, a global diagnostics company, is seeking a mid-level Reimbursement Specialist for a full-time remote role. The position centers on insurance billing lifecycle activities, including eligibility checks, claim submissions, and denials management, to ensure timely reimbursements while maintaining HIPAA compliance.

Ideal candidates have 2+ years in medical billing, proficiency with Excel and payer portals, and experience with Epic/XiFin/Quadax and Salesforce.

Qualifications

• High school diploma or GED; associate or bachelor's degree preferred in healthcare administration, business, or related field.
• 2+ years of experience in medical billing, insurance claims, or revenue cycle operations.
• Experience with payer portals and claim tracking systems.
• Familiarity with HIPAA compliance and healthcare privacy regulations.
• Experience with CRM systems (Salesforce) and Billing Software (Epic, XiFin, Quadax).
• Familiarity with ICD and HCPCS/CPT coding and CMS 1500 claim forms.

Responsibilities

• Research billing issues, trends and risks.
• Ensure claims are submitted with pre-claim requirements.
• Track claim status and generate reports (Excel).
• Address denied/unpaid claims via resubmission or appeals.
• Provide administrative support and update records as needed.
• Navigate payor portals to check eligibility, prior auth, and claim statuses.
• Apply payer guidelines to daily decisions and assist patients with financial navigation.

Skills

Microsoft Excel

Attention to detail

Analytical skills

Communication skills

Time management

Interpersonal skills

Education

High school diploma or GED

Associate's or bachelor's degree in healthcare administration or related field

Tools

Epic

XiFin

Quadax

Salesforce

Job description

At Veracyte, we offer exciting career opportunities for those interested in joining a pioneering team that is committed to transforming cancer care for patients across the globe. Working at Veracyte enables our employees to not only make a meaningful impact on the lives of patients, but to also learn and grow within a purpose drivenenvironment. This is what we call the Veracyte way its about how we work together, guided by our values, to give clinicians the insights they need to help patients make life-changing decisions.

Our Values:

• We Seek A Better Way: We pursue bold ideas, embrace complexity, and keep pushing forward.
• We Make It Happen: We act with urgency, deliver with excellence, and always find a way.
• We Are Stronger Together: We engage with empathy, align around what's best for Veracyte, and celebrate as one team.
• We Care Deeply: We show up with integrity, kindness, and respect for one another.

The Position

* This is a full-time, non-exempt, remote role with a schedule of Monday through Friday, 8:00am-5:00pm (PST or CST).

We are hiring a mid-levelReimbursement specialist to join our team. As a Reimbursement specialist, you will be a critical part of empowering Veracyte to achieve its mission of delivering transformative cancer care to patients by ensuring Veracyte gets reimbursed accurately and in a timely manner. Your primary role will be to take part in the day-to-day operations of the insurance billing life cycle to facilitate a smooth reimbursement process (i.e., verifying patient insurance coverage and benefits, ensuring timely insurance claim submissions, payment posting, performing A/R Follow-Up, sending appeals et al.). To accomplish this, you will need to work with insurance companies, internal teams, customers and patients with compassion and clarity while also having strong knowledge of healthcare reimbursement systems, insurance regulations, and compliance standards.

Responsibilities include:

• Researching and monitoring specific billing issues, trends and potential risks
• Reviewing and ensuring claims are submitted accurately with all pre-claim requirements.
• Ability to track the status of claims and pull reports to manage work (especially in Excel)
• Review denied/unpaid claims and take appropriate corrective action with minimal guidance (i.e., resubmission, appeal etc.)
• When requested, providing administrative support for department(s) including but not limited to performing data entry, updating various record keeping systems, upholding company policies and Client requirements, and participating in projects, duties, and other administrative tasks.
• Navigating payor portals, website or phone systems to check Eligibility, Prior Auth, Claim or Appeal statuses to obtain information needed to move claims forward in the life cycle
• Knowledge of payer guidelines and policies with ability to integrate it into daily decision making
• Assisting patients with navigating the financial journey with compassion and accuracy.
• Verifying insurance/recipient benefits with Medicare, Medicaid and Private Insurer Payers.
• Ensuring accurate and timely completion of billing responsibilities each day
• Reviewing and interpreting explanation of benefits

Who You Are

Education

• High school diploma or GED
• Associate's or bachelor's degree in healthcare administration, business, or related field preferred

Experience/Qualifications

• Use of personal computer, computer applications, and general office equipment.
• Experience with Microsoft Office (especially Word and Excel)
• 2+ years of experience in medical billing, insurance claims, or revenue cycle operations
• Experience with payer portals and claim tracking systems
• Familiarity with HIPAA compliance and healthcare privacy regulations
• Experience working with in CRMs (i.e., Salesforce) and Billing Software (i.e., Epic, XiFin, Quadax)
• Strong, consistent work ethic with attention to detail and ability to focus on the big picture.
• Ability to use analytical, interpersonal, communication, organizational, numerical, and time management skills.
• Good organization skills with ability to meet deadlines and manage several projects at a time.
• Enthusiasm and an entrepreneurial spirit
• Familiarity with ICD and HCPCS/CPT coding preferred.
• Familiarity with CMS 1500 claim form preferred.
• Familiarity with Claim Adjustment Reason Codes (NUCC) preferred.

Pay range

$24.82 — $33.59 USD

What We Can Offer You

Veracyte is a growing company that offers significant career opportunities if you are curious, driven, patient-oriented and aspire to help us build a great company. We offer competitive compensation and benefits, and are committed to fostering an inclusive workforce, where diverse backgrounds are represented, engaged, and empowered to drive innovative ideas and decisions. We are thrilled to be recognized as a 2024 Certified Great Place to Work in both the US and Israel - a testament to our dynamic, inclusive, and inspiring workplace where passion meets purpose.

About Veracyte

Veracyte(Nasdaq: VCYT) is a global diagnostics company whose vision is to transform cancer care for patients all over the world. We empower clinicians with the high-value insights they need to guide and assure patients at pivotal moments in the race to diagnose and treat cancer. Our Veracyte Diagnostics Platform delivers high-performing cancer tests that are fueled by broad genomic and clinical data, deep bioinformatic and AI capabilities, and a powerful evidence-generation engine, which ultimately drives durable reimbursement and guideline inclusion for our tests, along with new insights to support continued innovation and pipeline development. For more information, please visit www.veracyte.com or follow us on LinkedIn or X (Twitter).

Veracyte, Inc. is an Equal Opportunity Employer and will consider all qualified applicants for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status or disability status. Veracyte participates in E-Verify in the United States. View our CCPA Disclosure Notice

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Equal employment opportunity, including veterans and individuals with disabilities.

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