Reimbursement Specialist II - Prior Authorization (9:00 AM - 5:30 PM CST, Monday - Friday Shift)

Guardant Health is a leading precision oncology company focused on helping conquer cancer globally through use of its proprietary tests, vast data sets and advanced analytics. The Guardant Health oncology platform leverages capabilities to drive commercial adoption, improve patient clinical outcomes and lower healthcare costs across all stages of the cancer care continuum. Guardant Health has commercially launched Guardant360®, Guardant360 CDx, Guardant360 TissueNext™, Guardant360 Response™, and GuardantOMNI® tests for advanced stage cancer patients, and Guardant Reveal™ for early-stage cancer patients. The Guardant Health screening portfolio, including the Shield™ test, aims to address the needs of individuals eligible for cancer screening.

Location: Remote, 3-Days Hybrid, and 5-Days Onsite Options 

Shift: 9:00 AM - 5:30 PM CST, Monday - Friday Shift

As a Reimbursement Specialist II – Prior Authorization, you are a seasoned expert within the revenue cycle team, driving impact through deep knowledge of insurance processes, payer policy, and prior authorization strategy. Based in Spring, Texas, you play a key role in ensuring patients receive timely access to care while maximizing reimbursement outcomes for the organization.

You will independently manage the full prior authorization lifecycle—navigating complex payer policies, securing timely approvals, and resolving escalated reimbursement issues. With your extensive background in healthcare billing and payer engagement, you will lead efforts to streamline processes, troubleshoot complex denials, and collaborate with team members and ordering physician offices to ensure seamless communication.  You will be responsible for managing documentation for appropriate payer communication, handling correspondence, and conducting insurance claim research.  You will contribute to the development and implementation of training programs.

In collaboration with Finance, Client Services, Account Managers, and our billing technology partners, you will champion best practices and contribute to a high-functioning, compliant billing operation. You’ll help build and maintain comprehensive documentation of payer requirements and support process improvement initiatives that increase efficiency and effectiveness across the department.

• Minimum of 5+ years of healthcare reimbursement experience, with a strong focus on prior authorization, insurance coordination, and payer relations.
• Expert-level knowledge of Medicare, Medicaid, and commercial payer authorization policies and appeals processes.
• Demonstrated success in managing complex, high-priority claims, including overturning denials through advanced appeal strategies and external reviews.
• Proficiency with revenue cycle tools and systems such as Xifin, payer portals, EDI enrollment, and merchant/payment solutions.
• Advanced Excel capabilities, including use of pivot tables, conditional logic, and trend analysis for reporting and decision-making.
• Proven track record of working cross-functionally with internal teams and external stakeholders to resolve reimbursement challenges.
• Strong written and verbal communication skills, with an ability to distill complex issues for both technical and non-technical audiences.
• Detail-oriented, self-motivated, and driven to identify process improvements that enhance operational performance.
• Experience with laboratory billing workflows and national/regional payer requirements is highly desirable.

Hybrid Work Model: At Guardant Health, we have defined days for in-person/onsite collaboration and work-from-home days for individual-focused time. All U.S. employees who live within 50 miles of a Guardant facility will be required to be onsite on Mondays, Tuesdays, and Thursdays. We have found aligning our scheduled in-office days allows our teams to do the best work and creates the focused thinking time our innovative work requires. At Guardant, our work model has created flexibility for better work-life balance while keeping teams connected to advance our science for our patients.

The US hourly range for this full-time position is $22.39 to $30.80. The range does not include benefits and, if applicable, overtime, bonus, commission, or equity. The range displayed reflects the minimum and maximum target for new hire salaries across all US locations for the posted role with the exception of any locations specifically referenced below (if any).

For positions based in Palo Alto, CA or Redwood City, CA, the hourly range for this full-time position is $26.34 to $36.22. The range does not include benefits and, if applicable, overtime, bonus, commission, or equity.

Within the range, individual pay is determined by work location and additional factors, including, but not limited to, job-related skills, experience, and relevant education or training. If you are selected to move forward, the recruiting team will provide details specific to the factors above.

Employee may be required to lift routine office supplies and use office equipment. Majority of the work is performed in a desk/office environment; however, there may be exposure to high noise levels, fumes, and biohazard material in the laboratory environment. Ability to sit for extended periods of time.

Guardant Health is committed to providing reasonable accommodations in our hiring processes for candidates with disabilities, long-term conditions, mental health conditions, or sincerely held religious beliefs. If you need support, please reach out to [email protected]

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.

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Please visit our career page at: http://www.guardanthealth.com/jobs/