Remote Senior Clinical Reimbursement Lead

Bazeta; United States; Remote; USD 90,000 - 130,000; Full time

Job summary

Veracyte is seeking a Senior Clinical Reimbursement Specialist in the United States. You will independently manage high-dollar pre- and post-service appeals, mentor junior staff, and drive improvements across the revenue cycle with advanced clinical judgment and payer policy expertise.

Join a cross-functional team focused on reducing denials and improving revenue capture, while navigating Level 2 appeals, external reviews, and payer escalations in a remote-capable environment.

Qualifications

• Active clinical licensure (e.g., RN/NP)
• Associate or Bachelor’s degree in nursing
• 3–5 years in healthcare reimbursement or revenue cycle
• 2+ years in prior authorization, denial management, or appeals
• Advanced understanding of payer medical policies and appeals processes
• Proven ability to mentor peers and lead informally

Responsibilities

• Independently manage complex pre- and post-service appeals across Level 1–2 and external reviews.
• Provide SME guidance on payer policies and clinical documentation.
• Own end-to-end resolution of assigned cases with escalation when warranted.
• Partner with clinicians and staff to coordinate peer review and required documentation.
• Mentor Clinical Reimbursement Specialists and coach on policy interpretation.
• Analyze denial patterns to identify root causes and drive improvements.
• Contribute to SOPs, templates, and tools to support revenue cycle.
• Monitor payer policy changes and implement remediations.

Skills

Clinical reimbursement

Prior authorization

Appeals management

Payer policies

Mentoring

Communication

Clinical licensure

Education

Associate or Bachelor's degree in nursing

Job description

Veracyte is seeking a Senior Clinical Reimbursement Specialist in the United States. You will independently manage high-dollar pre- and post-service appeals, mentor junior staff, and drive improvements across the revenue cycle with advanced clinical judgment and payer policy expertise.

Join a cross-functional team focused on reducing denials and improving revenue capture, while navigating Level 2 appeals, external reviews, and payer escalations in a remote-capable environment.