Insurance Reimbursement Specialist

CareDx, Inc.

Job Overview

Location

Brisbane, CA

Job Type

Full-time

Full Job Description

📋 Description

• The Insurance Reimbursement Specialist is a full-time position responsible for maximizing reimbursement by collecting outstanding balances from insurance companies.
• The Specialist will follow up on unresolved claims and appeals, and escalate claims for reconsiderations and up to three levels of appeals.
• The role requires meticulous work and the ability to thrive in a fast-paced environment.
• The Specialist will work closely with the CareDx Payer Dispute Resolution and Market Access teams to ensure CareDx receives coverage and appropriate reimbursement from contracted and non-contracted payers and government health plans.
• The Specialist will be responsible for claim follow-up, denials, and appeals.
• The Specialist will prioritize an assigned work queue to ensure timely work is balanced with working the most payable claims.
• The Specialist will identify non-payment trends and, in collaboration with Revenue Cycle leadership, escalate groups of claims to the CareDx Payer Dispute Resolution or Market Access teams.
• The Specialist will investigate denial and non-payment trends identified by the Revenue Cycle Analytics team.
• The Specialist will propose solutions and collaborate cross-functionally with the Denials Management Steering Committee.
• The Specialist will share opportunities to improve upstream work to prevent denials.
• The Specialist will work with patients when their assistance is needed in the appeal process.
• The Specialist will work professionally with Revenue Cycle teammates to be responsive to requests that require their assistance.

🎯 Requirements

• Education: High school diploma or equivalent.
• Experience: 3-5 years’ experience in medical billing; strong preference will be given to candidates with molecular laboratory billing experience.
• Understanding of patient protections under HIPAA and proper handling of protected health information (PHI).
• Working knowledge of health insurance and terminology.
• Excellent communication and people skills.
• Meticulous with strong analytical and problem-solving abilities.

🏖️ Benefits

• Competitive base salary and incentive compensation.
• Health and welfare benefits, including a gym reimbursement program.
• 401(k) savings plan match.
• Employee Stock Purchase Plan.
• Pre-tax commuter benefits.
• IMPORTANT CATEGORIZATION:
• Management
• IMPORTANT LOCATION EXTRACTION:
• "city": Brisbane
• "region": CA
• "country_code": US
• "is_remote": false
• IMPORTANT RULES:
• PAY ATTENTION TO THE JOB TITLE ABOVE ALL ELSE.
• If the title says 'HR', 'Recruiter', or 'People', do NOT categorize as 'Data Science' even if description mentions data/metrics.
• If the title says 'Data Scientist', do NOT categorize as 'Software Engineering'.
• Use the description only to clarify if the title is ambiguous.
• Select the most specific child category if applicable (e.g., "Android Developer" instead of "Engineering").
• If no specific child matches, select the most appropriate parent category (e.g., "Engineering" if it's a generic developer role).
• If the job DOES NOT confidently match ANY of the categories, you MUST return "Other".
• Available Categories:
• Accounting:
• Customer Success:
• Customer Support:
• Cybersecurity:
• Data & Analytics:
• Data Science:
• Design:
• Creative Director, Design Manager, Graphic Designer, Product Designer, User Researcher, Visual Designer
• DevOps & SysAdmin:
• Engineering:
• Android Developer, Backend Engineer, Data Engineer, Data Scientist, DevOps, Embedded Engineer, Engineering Manager, Frontend Engineer, Full-Stack Engineer, iOS Developer, Machine Learning Engineer, Mobile Developer, QA Engineer, Security Engineer, Software Architect, Software Engineer
• Finance:
• HR & Recruiting:
• Human Resources:
• Management:
• Chief Executive Officer (CEO), Chief Financial Officer (CFO), Chief Marketing Officer (CMO), Chief Operating Officer (COO), Chief Technology Officer (CTO)
• Marketing:
• Content Creator, Copywriter, Digital Marketing Manager, Growth Hacker, Marketing Manager, Product Marketing Manager, Social Media Manager
• Operations:
• Chief of Staff, Customer Service, Finance/Accounting, H.R., Office Manager, Operations Manager, Recruiter
• Other:
• Business Analyst, Data Analyst, Project Manager
• Other Engineering:
• Hardware Engineer, Mechanical Engineer, Systems Engineer
• Product:
• Product Manager
• Product Management:
• Sales:
• Account Executive, Account Manager, Business Development, Business Development Manager, Customer Success Manager, Sales Manager
• Software Development:
• Software Engineering:
• Writing:
• Return **only** one raw JSON object in this exact shape:
• {
• "description": "",
• "requirements": [
• "requirement 1",
• "requirement 2",
• "requirement 3"
• ],
• "benefits": [
• "benefit 1",
• "benefit 2",
• "benefit 3"
• ],

Skills & Technologies

Remote

Degree Required

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CareDx, Inc.

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About CareDx, Inc.

CareDx, Inc. is a precision medicine company focused on the discovery, development, and commercialization of clinically differentiated, high-value healthcare solutions for transplant patients and caregivers. It develops and markets non-invasive diagnostics that use cell-free DNA to monitor organ rejection and transplant health, including AlloSure for kidney, AlloMap Heart, and AlloSure Lung tests. The company also offers AlloCare patient app and RemoTrac mobile phlebotomy services to support remote monitoring and improve patient adherence. CareDx serves transplant centers, physicians, and patients across the United States and internationally, aiming to enhance long-term outcomes and quality of life for transplant recipients.

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