Mgr, Reimbursement

CareDx, Inc. is a leading precision medicine solutions company focused on the discovery, development, and commercialization of clinically differentiated, high-value healthcare solutions for transplant patients and caregivers. CareDx offers products, testing services, and digital healthcare solutions along the pre- and post-transplant patient journey, and is the leading provider of genomics-based information for transplant patients.

The Manager promotes efficiency and assists the revenue cycle department in resolving revenue cycle problems. They supervise and oversee staff in duties pertaining to patient billing, communications with health insurance, collections, cash posting, account management, and contract analysis. Duties include working billing queues as part of a team.

Responsibilities:

• Strong knowledge for vendor relations: Frontrunner, Glidian and Careviso (Cover My Test)
• Strong knowledge of billing software: Telcor, Quadax, Waystar and Xifin
• Strong understanding of insurance and benefit design with both commercial and government payers
• Background in Access & Reimbursement, Payer account management, Patient Services, Case Management
• Successful navigation of complex authorization processes for diagnostic testing; unlisted cpt codes (Pre-determinations and appeals)
• Working with a Patient Service Center/Hub to design case-specific strategies based on payer mix, benefit design, and authorization requirements.
• Coordinating case pull-through with the Market Access/Managed Care, Case Managers, Sales, and RCM Leadership
• Field responsibilities that include supporting and educating HCP offices on best practices that streamline the authorization process and expedite treatment access for patients
• Experience work with
• Demonstrated analytical, problem solving, and relationship-building skills
• QA and QC on cases; weekly
• Conduct monthly and routine 1:1s with staff; Mid-Year and Yearly reviews
• Provide process improvement feedback on existing workflows

Qualifications:

• Bachelor's or higher degree preferred; or experience related to industry
• Minimum of 5 years of Managerial experience
• Minimum of 5 years' experience working with diagnostic laboratory testing
• Minimum of 3 years' access-related position (FAP, PAP)
• Excellent communication, organizational and leadership skills
• Implementing measures that enable metrics for sub-team

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 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!

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 and participates in the E-Verify program.

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