Supervisor, Reimbursement - Prior Authorization

Guardant Health; United States; On-site; USD 80,070 - 110,075; Full time

Job summary

Guardant Health is seeking a Supervisor, Reimbursement Prior Authorization to drive payment for services and optimize billing operations. You will lead the authorization team, ensure timely documentation, and collaborate with Finance and Client Services to align with company goals.

The role requires strong leadership, HIPAA compliance, and knowledge of payer requirements. This is a hybrid position with a remote-open stance across the USA and a base pay range outlined in the compensation section.

Qualifications

• Minimum 3 years of healthcare revenue cycle management experience.
• At least 1 year of leadership experience.
• Excellent leadership and team management skills.
• Knowledge of medical terminology, CPT and ICD coding.
• Experience with contacting insurance carriers, file reconsideration requests, appeals, and negotiations.
• Proficiency with Microsoft Excel and data analysis.
• Familiarity with Xifin, Telcor and payer portals is a plus.

Responsibilities

• Serve as the knowledge expert and information source for staff and stakeholders.
• Ensure compliance with contract requirements, policies, procedures, and standards.
• Monitor authorization requests inventory for resource allocation.
• Maintain knowledge of contract requirements, policies, procedures, and standards.
• Assist in the reimbursement appeals process with documentation/tracking.
• Identify process improvements within authorization request workflows.
• Provide coaching to staff to meet productivity and documentation goals.
• Monitor risks and develop action plans with leadership.
• Support onboarding, hiring, and training of staff; update job aids.

Skills

Leadership

Communication

Attention to detail

CPT/ICD coding

Excel

Payer portals

Education

High school diploma or equivalent

Tools

Xifin

Telcor

Microsoft Office

Job description

Company Description

Guardant Health is a leading precision oncology company focused on guarding wellness and giving every person more time free from cancer. Founded in 2012, Guardant® is transforming patient care and accelerating new cancer therapies by providing critical insights into what drives disease through its advanced blood and tissue tests, real‑world data and AI analytics. Guardant tests help improve outcomes across all stages of care, including screening to find cancer early, monitoring for recurrence in early‑stage cancer, and treatment selection for patients with advanced cancer.

Role Overview

As a Supervisor, Reimbursement Prior Authorization, you play an important role in the overall success of the company. Working with our billing tool provider, you will drive payment for our services and partner with colleagues in Finance and Client Services to facilitate optimized billing processes and operations aligned with Guardant Health’s mission and values.

You are responsible for facilitating the prior authorization request process for required authorizations to ensure the work queue is managed and addressed properly and timely. You will manage day‑to‑day activities and provide guidance to the authorization team on documenting and resolving all authorization requests and/or issues to ensure accurate and timely documentation for services related to member healthcare eligibility and access. You will be expected to be knowledgeable of, and be able to perform, the duties of the staff supervised. Strong communication and troubleshooting skills are required.

Essential Duties and Responsibilities

• Serve as the knowledge expert and information source for staff and key stakeholders.
• Ensure authorization team’s compliance with contract requirements, policies, procedures, and performance standards.
• Monitor authorization requests inventory to ensure proper resource allocation throughout the day.
• Maintain knowledge of contract requirements, policies, procedures, and performance standards.
• Assist in the reimbursement appeals process by providing chronological documentation/tracking of prior‑authorization verification and advisor follow‑up for cases under review.
• Work with the authorization team and senior management to identify opportunities for process and quality improvements within authorization request processes.
• Evaluate authorization team performance and provide feedback regarding performance, goals, and career milestones.
• Provide coaching and guidance to authorization team and department productivity goals to ensure accurate and timely documentation for services and improve processing and quality of authorization requests.
• Proactively monitor for organizational risks, communicate risks to leadership, and develop action plans to mitigate risks.
• Assist with onboarding, hiring, and training authorization team members; participate in developing and/or updating job aids, training modules, workflows, and implementing change management strategies.
• Manage the import and export of documents through insurance portals, ensuring timely submission of prior authorization requests, ensuring accuracy and compliance with procedures.
• Follow appropriate HIPAA guidelines.
• Work well individually and in a team environment, accomplishing set KPI goals.
• Perform other related duties as assigned to support the overall efficiency of the department.

Travel & Related Responsibilities

• Participate in corporate events and quarterly/biannually/annual meetings to connect with fellow leaders and share innovative strategies.
• Engage in leadership development opportunities and conferences that enhance your skills and knowledge, empowering you to lead your team effectively.
• Initiate and participate in team‑building activities in person with direct reports and collaborate with cross‑functional teams to foster a strong, united workplace culture.

Qualifications

• High school diploma or equivalent degree from an accredited college or university in business, healthcare administration, or related major (relevant experience may be considered in lieu of degree).
• A minimum of 3years of recent experience in both professional healthcare revenue cycle management, and at least 1year of related experience in a leadership role reflective of this position.
• Excellent leadership and team management skills.
• Exceptional attention to detail and accuracy.
• Knowledge of medical terminology, CPT and ICD coding.
• Knowledge in managed care requirements as they relate to reimbursement, including US Commercial, Medicare, Medicaid, and third‑party payer reimbursement.
• Experience with contacting and following up with insurance carriers, file reconsideration requests, formal appeals, and negotiations.
• Proficiency using a computer, PC software, specifically Microsoft Office Suite, particularly Excel, and above‑average typing skills.
• Excellent written and verbal communication skills.
• Familiarity with laboratory billing, Xifin, Telcor, payer portals and national as well as regional payers throughout the country is a plus.
• Ability to effectively incorporate the mission and core values into processes and workflows.
• Effective interpersonal skills to facilitate work in a team environment and to collaborate with a variety of professionals.
• Strong decision‑making and self‑motivation skills.
• Strong problem‑solving skills and ability to troubleshoot issues effectively.

Work Environment

Majority of the work is performed in a desk/office environment. The role may require the ability to sit/stand for extended periods of time, lift routine office supplies, and use office equipment. Exposure to high noise levels, fumes, and biohazard material may occur in laboratory settings.

AI & Digital Fluency

• Demonstrate curiosity, sound judgment, and the ability to critically evaluate and responsibly leverage AI‑enabled tools in accordance with company policies, ethical standards, and regulatory requirements to improve the efficiency, effectiveness, and quality of work.

Hybrid Work Model

This section is applicable to onsite employees who are eligible for a hybrid work location as specified by management and related policies. Guardant defines days for in‑person/on‑site collaboration and work‑from‑home days for individual‑focused time. All U.S. employees who live within 50miles of a Guardant facility will be required to be onsite on Mondays, Tuesdays, and Thursdays. The model provides flexibility for better work‑life balance while keeping teams connected to advance science for patients.

Compensation

Primary Location: Remote – Open Position (USA)

Primary Location Base Pay Range: $80,070 – $110,075

Other U.S. Location(s) Base Pay Range: $80,070 – $110,075

If the role is performed in Colorado, the pay range is: $84,780 – $116,550

Equal Opportunity Employer

Guardant Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, or protected veteran status and will not be discriminated against on the basis of disability.

All your information will be kept confidential according to EEO guidelines.

Background Screening

A background screening, including criminal history, is required for this role. Guardant Health will consider qualified applicants with criminal arrest or conviction histories in a manner consistent with applicable law, including but not limited to the LA County Fair Chance Policies and the Fair Chance Act (Gov. Code Section 12952).