Financial Clearance Specialist
CareDx, Inc.
Summary
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.
Job description
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.
- Accurately document eligibility information in the revenue cycle management system.
- 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.
Requirements
- 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
- Experience with laboratory billing software (Telcor, Xifin, or Quadax) preferred
Benefits
- Competitive base salary
- Incentive compensation
- Health and welfare benefits
- Gym reimbursement program
- 401(k) savings plan match
- Employee stock purchase plan
- Pre-tax commuter benefits
- Living donor recovery policy
Company overview
CareDx, Inc. is a leading precision medicine company specializing in transplant diagnostics and patient care solutions. Founded 25 years ago, the company focuses on the discovery, development, and commercialization of clinically differentiated, high-value diagnostic solutions for transplant patients and caregivers. Headquartered in Brisbane, California, with operations across the United States, Europe, and Australia, CareDx offers a comprehensive portfolio of non-invasive surveillance tests including AlloMap® Heart (gene expression testing), AlloSure® Kidney, Heart, and Lung (donor-derived cell-free DNA solutions), and HeartCare® (multimodality testing). The company also provides lab products for HLA typing, digital transplant solutions for patient management, and specialized transplant pharmacy services. With approximately 651 employees as of 2024, CareDx has established itself as the leading provider of genomics-based information for transplant patients, generating $333.8 million in revenue in 2024. The company's innovative approach combines advanced genomics, bioinformatics, and clinical evidence to transform transplant patient care throughout the entire transplant journey.