Full-Time
Reimbursement Specialist II
Follow Up & Appeals, Screening
Guardant Health
1,001-5,000 employees
Blood-based tests for cancer detection and management
No salary listed
Mid
Palo Alto, CA, USA
- 3+ years of experience in healthcare reimbursement, with a solid understanding of health plan regulations, payer policies, and claims processing
- Basic proficiency in Excel (sorting, filtering, simple formulas)
- Strong communication skills with the ability to navigate complex scenarios and maintain professional relationships with payers and colleagues
- Proven ability to work independently, prioritize tasks, and manage multiple claims efficiently
- Monitor and manage complex outstanding insurance claims, ensuring timely follow-up and resolution
- Troubleshoot Explanation of Benefits (EOBs) and identify reasons for claim denials or low payments
- Prepare and submit appeals for non-covered services, low payments, or disputed claims, aiming to secure positive coverage determinations through external appeals
- Maintain detailed documentation of payer communications, claim statuses, and research activities
- Collaborate with internal teams and external payers to resolve billing issues and improve reimbursement outcomes
- Familiarity with laboratory billing systems, Xifin, EDI enrollment, payer portals, and regional/national payers
Guardant Health specializes in blood-based tests that provide essential information for cancer treatment and management. Their main product, Guardant360, is an FDA-approved test that helps healthcare providers make informed treatment decisions for patients with advanced cancer. The company uses blood samples to detect and monitor cancer, making their tests non-invasive and data-rich. Unlike many competitors, Guardant Health is also expanding its offerings to include tests for early-stage cancer detection and monitoring for recurrence. The goal of Guardant Health is to enhance patient outcomes and lessen the impact of cancer on individuals and healthcare systems.
Company Size
1,001-5,000
Company Stage
IPO
Headquarters
Palo Alto, California
Founded
2012
Simplify's Take
What believers are saying
- Guardant Health won the 2025 World Changing Ideas Award for colorectal cancer screening.
- They partnered with Pfizer to develop cancer therapies using liquid biopsy technology.
- Guardant Health is expanding into early-stage cancer detection and recurrence monitoring.
What critics are saying
- Increased competition from Caris Life Sciences may impact market share and pricing power.
- Rapid technological advancements may outpace Guardant Health's product integration capabilities.
- Expansion into hereditary cancer testing may lead to increased regulatory scrutiny.
What makes Guardant Health unique
- Guardant Health specializes in blood-based tests for cancer treatment and management.
- Their flagship product, Guardant360, is FDA-approved for advanced cancer treatment decisions.
- They focus on non-invasive diagnostics to improve patient outcomes and reduce cancer burden.
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Benefits
Professional Development Budget
Performance Bonus
Growth & Insights and Company News
6 month growth
↓ -1%1 year growth
↑ 0%2 year growth
↓ -1%Guardant Health wins Fast Company's 2025 World Changing Ideas Award for Shield blood test for colorectal cancer screening.
Competitive landscape: Caris competes with Roche's Foundation Medicine, Guardant Health, Grail, and peers like Tempus AI.
WASHINGTON, June 4, 2025 /PRNewswire/ -- A collection of public and private sector health leaders today announced a new collaboration to help ensure current health screening measures remain aligned with the rapid advancements in FDA-approved screening technologies and clinical guidelines.The Alliance for Screening Measurement Modernization (ASMM) brings together organizations from across the healthcare sector to explore a broader framework for the timely integration of evidence into currently endorsed national health screening policies."It is critically important that clinicians have what they need to keep patients healthy, including the latest diagnostics," said Lee Fleisher, M.D., M.L., ASMM chair and founder of Rubrum Advising. "The pace of technology is accelerating rapidly, but it can take more than a decade to update the quality measures that assess compliance with current health screening recommendations. This means clinicians are not incentivized to use tests that may be quicker, safer, or less invasive for patients simply because they are built on technologies that have not yet been incorporated into the latest quality measures."Over the next six months, ASMM will:Develop a replicable, transparent framework to support measure developers with timely and appropriate pathways to update currently endorsed screening quality measuresto support measure developers with timely and appropriate pathways to update currently endorsed screening quality measures Enable the evidence-based inclusion of innovative technologies that improve diagnostic speed, accuracy, and accessibilitythat improve diagnostic speed, accuracy, and accessibility Submit a consensus white paper and policy briefs to Congressional and federal agencies for considerationASMM is led by two independent but collaborative bodies: the ASMM Quality Council, whose members are guideline-setting groups and non-profit organizations, and the Industry Council, which includes organizations that are at the forefront of transforming screening technologies to support more accurate, accessible, and timely diagnoses.The Quality Council is developing the framework and will operate independently of the Industry Council, which serves as the central forum to ensure diagnostic and imaging innovators and stakeholders have a voice in the process. Together, the councils represent a range of therapeutic areas and reflect expertise in both clinical practice and quality measure development and policy.Industry Council founding members include Geneoscopy and Guardant Health and founding members of the Quality Council include ECRI, Friends of Cancer Research, Milken Institute's FasterCures, URAC, and others.SOURCE The Alliance for Screening Measurement Modernization
Guardant Health, Inc. (NASDAQ:GH) and research collaborators have unveiled results from the largest study to date on circulating tumor DNA (ctDNA) testing in stage III colon cancer, presented at the 2025 ASCO Annual Meeting.
Guardant Health introduces nearly a dozen groundbreaking Smart Liquid Biopsy applications for Guardant360 Liquid test.