Senior Clinical Reimbursement Strategist (Remote)

Veracyte, Inc.; United States; Remote; USD 86,000 - 138,000; Full time

Job summary

Veracyte, Inc. is hiring a Senior Clinical Reimbursement Specialist to lead complex payer appeals and analyst work within the Clinical Reimbursement Operations team.

You will mentor junior staff, design improvements, and apply advanced clinical judgment across Level 1–External reviews to improve revenue capture. The role requires nursing licensure, a degree in nursing, and 3–5 years in reimbursement or revenue cycle roles, with strong policy interpretation and cross-functional collaboration

Qualifications

• Active clinical licensure and nursing degree required.
• 3–5 years in healthcare reimbursement or revenue cycle roles.
• 2+ years in prior authorization, denial management, or appeals.
• Strong ability to mentor peers and lead without formal authority.

Responsibilities

• Independently manage complex pre- and post-service appeals across levels.
• Translate payer policies into patient-specific clinical justification for cases.
• Own end-to-end resolution with follow-up and escalation when needed.
• Lead development of SOPs, templates, and workflow tools.
• Monitor payer policy changes and drive remediations.

Skills

Excellent communication

Clinical reimbursement knowledge

Mentoring / SME support

Education

Associate or Bachelor's degree in nursing

Active clinical licensure (RN, NP)

Tools

SOP development

Workflow tools

Job description

Veracyte, Inc. is hiring a Senior Clinical Reimbursement Specialist to lead complex payer appeals and analyst work within the Clinical Reimbursement Operations team.

You will mentor junior staff, design improvements, and apply advanced clinical judgment across Level 1–External reviews to improve revenue capture. The role requires nursing licensure, a degree in nursing, and 3–5 years in reimbursement or revenue cycle roles, with strong policy interpretation and cross-functional collaboration