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Financial Clearance Specialist

Role overview

Summary

The Financial Clearance Specialist is responsible for the timely and accurate financial clearance of patient accounts at CareDx. This role focuses on eligibility verification and claim error processing, ensuring compliance with policies while collaborating with various stakeholders to resolve discrepancies.

Qualifications

  • High school diploma or equivalent.
  • Minimum of 2 years of experience in a medical billing or financial clearance role.
  • Understanding of patient protections under HIPAA and proper handling of protected health information (PHI).
  • Working knowledge of insurance policies, billing procedures, and claim terminology.
  • Excellent communication and people skills.

Responsibilities

  • Conduct thorough reviews of patient insurance coverage and benefit eligibility for laboratory services.
  • Communicate with CareDx teammates, clinics, patients, and insurance companies to verify coverage details and resolve any discrepancies.
  • Efficiently analyze and resolve claim errors identified by the revenue cycle management system, including coding and billing discrepancies.
  • Collaborate with teammates to resolve errors and ensure compliance with policies and procedures.

Key facts

  • Remote from: United States
  • Full time
  • Mid-level (2-5 years)
  • Finance Specialist
  • $46K – $65K / year
  • English

Hard skills

Other skills

  • Communication
  • Analytical Skills
  • Problem Solving
  • Detail Oriented

About the company

CareDx, Inc. logo

CareDx, Inc.

  • Diagnostics & Laboratories
  • SME
  • 501–1,000
CareDx: Transforming Transplant Patient Care Through Novel Surveillance Management Solutions CareDx, Inc. is dedicated to improving the lives of organ transplant patients through non-invasive diagnostics. By combining the latest advances in genomics and bioinformatics technology, with a commitment to generating high quality clinical evidence through trials and registries, CareDx is at the forefront of organ transplant surveillance and pre-transplant HLA typing solutions. NASDAQ:CDNA About AlloSure® AlloSure is the first and only non-invasive blood test that directly measures allograft injury and identifies the probability of active rejection to better manage kidney transplant patients. AlloSure is a clinical-grade, proprietary Next-Generation Sequencing (NGS) based test to detect donor-derived cell-free DNA (dd-cfDNA) in order to identify organ injury in kidney transplant recipients. AlloSure is analytically validated as a sensitive, specific, and precise measurement of dd-cfDNA. AlloSure detects active rejection (acute active ABMR, chronic active ABMR, or TCMR) with high accuracy, outperforms serum creatinine in kidney transplant recipients, and is highly sensitive in distinguishing ABMR from no ABMR. AlloSure is performed in the CareDx CLIA-certified laboratory. http://www.allosure.com/ About AlloMap® AlloMap Molecular Expression Testing is a non-invasive blood test used to aid in the identification of heart transplant recipients with stable allograft function who have a low probability of moderate/severe acute cellular rejection at the time of testing in conjunction with standard clinical assessment. AlloMap testing measures the expression levels of 20 genes from a blood sample. The combined expression of these genes is represented as an AlloMap test score. AlloMap is performed in the CareDx CLIA-certified laboratory and has been commercially available in the United States since 2005. AlloMap was cleared by the U.S. Food and Drug Administration in 2008 and was CE marked for the European Union in 2011. Use of AlloMap is also included in the International Society for Heart and Lung Transplantation (ISHLT) Practice Guidelines, published in August 2010, the worldwide standard for the care of heart transplant patients. http://www.allomap.com/

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Job description

CareDx is a leading precision medicine diagnostics company advancing care in transplant, specialty oncology, and cell therapy. Through our innovative portfolio of molecular diagnostics, digital health solutions, AI-powered data and analytics, and patient support services, we partner with healthcare providers, patients, and biopharma organizations to help inform clinical decision-making and improve patient outcomes.

At CareDx, every employee has the opportunity to contribute to innovations that help transform patient care and improve lives.

The primary responsibility of the Financial Clearance Specialist is to ensure timely and accurate financial clearance of patient accounts. The Specialist will primarily focus on eligibility verification, resolving missing claim elements, and ensuring timely submission of clean claims to insurance companies. This role requires meticulous work and the ability to thrive in a fast-paced environment. This is a full-time position, Monday through Friday, with occasional overtime as needed. Candidates within commuting distance of the Brisbane, California office will need to come to the office on a regular basis; remote candidates will work and collaborate from home.

Responsibilities: 

Eligibility Verification:

  • Conduct thorough reviews of patient insurance coverage and benefit eligibility for laboratory services.
  • Communicate with CareDx teammates, clinics, patients, and insurance companies to verify coverage details and resolve any discrepancies.
  • Accurately document eligibility information in the revenue cycle management system.

Claim Error Processing:

  • Efficiently analyze and resolve claim errors identified by the revenue cycle management system, including coding and billing discrepancies.
  • Collaborate with teammates to resolve errors and ensure compliance with policies and procedures.
  • Understand and resolve discrepancies related to medical necessity.
  • Other duties as assigned.

Minimum Education, Experience, & Specialized Knowledge (Required): 

  • High school diploma or equivalent.
  • Minimum of 2 years of experience in a medical billing or financial clearance role.
  • Understanding of patient protections under HIPAA and proper handling of protected health information (PHI).
  • Working knowledge of insurance policies, billing procedures, and claim terminology.
  • Excellent communication and people skills.
  • Detail-oriented with strong analytical and problem-solving abilities.
  • Preference will be given to qualified candidates with experience with laboratory billing software, including Telcor, Xifin or Quadax.

Additional Details: 

Every individual at CareDx has a direct impact on our collective mission to improve the lives of organ transplant patients worldwide. We believe in taking great care of our people, so they take even greater care of our patients. 

Our competitive Total Rewards package for US Employees includes:

  • 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
  • And more!
  • Please refer to our page to view detailed benefits at https://caredx.com/company/careers

In addition, we have a Living Donor Employee Recovery Policy that allows up to 30 days of paid leave annually to a full-time employee who makes the selfless act of donating an organ or bone marrow.

With products that are making a difference in the lives of transplant patients today and a promising pipeline for the future, it’s an exciting time to be part of the CareDx team. Join us in partnering with transplant patients to transform our future together.

CareDx, Inc. is an Equal Opportunity Employer-vets/disabled, and participates in the E-Verify program. By proceeding with our application and submitting your information, you acknowledge that you have read our U.S. Personnel Privacy Noticeand consent to receive email communication from CareDx. Certain jurisdictions require notice of how we use and protect your personal information. For more information, please read our Privacy Policy

The U.S. EEO posters are available here. 

Note: We do not accept resumes from headhunters, placement agencies, or other suppliers that have not signed a formal agreement with us. 

#LI-Remote

This is the anticipated base salary range in the United States. The final salary offered to a successful candidate will be dependent on several factors that may include, but are not limited to, the type and length of experience within the job, the type and length of experience within the industry, education, etc. Base pay is one part of the Total Package that is provided to compensate and recognize employees for their work, and this role may be eligible for additional discretionary bonuses/incentives and restricted stock units. CareDx is a multi-state employer, and this salary range may not reflect positions that work in other states.

Remote: US only roles$24.05—$33.65 USD

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