Reimbursement, Reimbursement Specialist (Claim Denial and Appeal Focus)(Remote)
Castle Biosciences Earns a Top Workplaces USA Award for the Fourth Consecutive Year!
You won't find a work culture and benefits package like ours every day. Come join our team and a group of colleagues who love working at Castle!
Castle Biosciences Inc. is growing, and we are looking to hire a Reimbursement Specialist (Claim Denial and Appeal Focus) working remotely from your home office based in the USA, with a start date prior to June 5, 2025.
We are in search of someone who strives for excellence in their work with a positive, can-do attitude! If this sounds like the right opportunity for you in the essential biotech field, consider applying today! Learn more at www.CastleBiosciences.com
EXCEPTIONAL BENEFIT PACKAGE
Excellent Annual Salary + Achievable Annual Bonus Potential 20% of Salary + 20 accrued PTO Days annually
401K with a 100% Company match of up to 6% of your allowable Contribution, and No Waiting Period
3 health care plan options, with very low premium cost + Company HSA Contribution with HDHP option + Company Stock Grant Upon Hire
A DAY IN THE LIFE OF Reimbursement Specialist (Claim Denial and Appeal Focus),
This individual is responsible for resolving denied insurance claims for laboratory services by providing payers with requested or additional documentation, initiating the appeal process on behalf of the patient, and delivering the highest level of customer service to both internal and external customers. The majority of time will be spent reviewing Explanation of Benefits (EOBs), electronic remittance advice, and denial letters, assigning appropriate ANSI codes, and taking necessary action within the billing system. This role will also involve placing calls to insurance companies to obtain missing information or determine the status of submitted claims as needed. Additionally, the individual will read and interpret medical record documents and payer medical policies to ensure that key "medical necessity" criteria are documented by the clinician. They will also create custom appeals with well-supported arguments to ensure denials are overturned based on payer medical policy or state laws.
REQUIRED QUALIFICATIONS
• Minimum Requirements
• High School Diploma or equivalent GED or equivalent work experience.
• Two years of health insurance billing with experience in identifying and resolving claim issues for laboratory tests.
• Must have a working knowledge of various payers' designations of authorized representative forms.
• Experience handling a high volume of claims work on a daily basis (35 plus claims per day)
• Proficient in Microsoft Excel, Word, and Outlook
• Strong analytics and problem-solving skills.
• Excellent customer service skills.
• Typing speed of 35 or more words per minute, with 90% or greater accuracy.
• One year minimum experience in a medical/healthcare Reimbursement Specialist role with one company.
• Actively displays behaviors that support the mission, vision, and values of Castle Biosciences.
• Please see the attached job description for additional roles, responsibilities, and requirements.
TRAVEL REQUIREMENTS
• Apply Now
You won't find a work culture and benefits package like ours every day. Come join our team and a group of colleagues who love working at Castle!
Castle Biosciences Inc. is growing, and we are looking to hire a Reimbursement Specialist (Claim Denial and Appeal Focus) working remotely from your home office based in the USA, with a start date prior to June 5, 2025.
We are in search of someone who strives for excellence in their work with a positive, can-do attitude! If this sounds like the right opportunity for you in the essential biotech field, consider applying today! Learn more at www.CastleBiosciences.com
EXCEPTIONAL BENEFIT PACKAGE
Excellent Annual Salary + Achievable Annual Bonus Potential 20% of Salary + 20 accrued PTO Days annually
401K with a 100% Company match of up to 6% of your allowable Contribution, and No Waiting Period
3 health care plan options, with very low premium cost + Company HSA Contribution with HDHP option + Company Stock Grant Upon Hire
A DAY IN THE LIFE OF Reimbursement Specialist (Claim Denial and Appeal Focus),
This individual is responsible for resolving denied insurance claims for laboratory services by providing payers with requested or additional documentation, initiating the appeal process on behalf of the patient, and delivering the highest level of customer service to both internal and external customers. The majority of time will be spent reviewing Explanation of Benefits (EOBs), electronic remittance advice, and denial letters, assigning appropriate ANSI codes, and taking necessary action within the billing system. This role will also involve placing calls to insurance companies to obtain missing information or determine the status of submitted claims as needed. Additionally, the individual will read and interpret medical record documents and payer medical policies to ensure that key "medical necessity" criteria are documented by the clinician. They will also create custom appeals with well-supported arguments to ensure denials are overturned based on payer medical policy or state laws.
REQUIRED QUALIFICATIONS
• Minimum Requirements
• High School Diploma or equivalent GED or equivalent work experience.
• Two years of health insurance billing with experience in identifying and resolving claim issues for laboratory tests.
• Must have a working knowledge of various payers' designations of authorized representative forms.
• Experience handling a high volume of claims work on a daily basis (35 plus claims per day)
• Proficient in Microsoft Excel, Word, and Outlook
• Strong analytics and problem-solving skills.
• Excellent customer service skills.
• Typing speed of 35 or more words per minute, with 90% or greater accuracy.
• One year minimum experience in a medical/healthcare Reimbursement Specialist role with one company.
• Actively displays behaviors that support the mission, vision, and values of Castle Biosciences.
• Please see the attached job description for additional roles, responsibilities, and requirements.
TRAVEL REQUIREMENTS
• Apply Now