Reimbursement Specialist

Responsibilities

• Research and monitor specific billing issues, trends, and potential risks
• Review and ensure claims are submitted accurately with all pre-claim requirements
• Track claim status and pull reports using Excel
• Review denied or unpaid claims and take corrective action such as resubmission or appeals
• Navigate payer portals and phone systems to check eligibility, prior authorization, and claim status
• Verify insurance and recipient benefits with Medicare, Medicaid, and private insurers
• Review and interpret explanation of benefits
• Assist patients with navigating their financial journey with compassion and accuracy

Requirements

• 2+ years of experience in medical billing, insurance claims, or revenue cycle operations
• High school diploma or GED required
• Proficiency with Microsoft Office, especially Excel and Word
• Experience with payer portals and claim tracking systems
• Familiarity with HIPAA compliance and healthcare privacy regulations
• Experience with CRMs like Salesforce and billing software such as Epic, XiFin, or Quadax

Preferred Qualifications

• Associate's or bachelor's degree in healthcare administration, business, or a related field
• Familiarity with ICD and HCPCS/CPT coding
• Familiarity with CMS 1500 claim forms
• Familiarity with Claim Adjustment Reason Codes (NUCC)

About the Company

Veracyte is a global diagnostics company dedicated to transforming cancer care. We empower clinicians with high-value insights to guide patients through pivotal moments in diagnosis and treatment using our advanced diagnostics platform.