Reimbursement, Reimbursement Specialist (Claim Denial and Appeal Focus)(Remote)

Job Description:

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!

Learn more at www.CastleBiosciences.com

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 September 16, 2025.

Why Castle Biosciences?

Total Compensation Package:

• Salary Range: $47,277.00. Final salary is based on Experience and Education levels.
• Excellent Annual Salary + 20% Bonus Potential
• 20 Accrued PTO Days Annually
• 10 Paid Holidays
• 401K with 100% Company Match up to 6%
• 3 Health Care Plan Options + Company HSA Contribution
• Company Stock Grant Upon Hire
• $75/month reimbursement for internet service

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
  • Two years of health insurance billing with experience in identifying and resolving medical claim issues, preferably for laboratory tests.
  • Must have experience resolving claim issues for procedures/tests that were denied after pre-approval and claim processing.
  • 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)
  • 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.

*Please see the attached job description for additional roles, responsibilities, and requirements.

TRAVEL REQUIREMENTS

• <5% as needed for training and meetings.

SCHEDULE

• Monday-Friday, 8:00 AM - 5:00 PM, non-exempt, working remotely from your home office based in the USA.

READY TO JOIN OUR BIOTECH TEAM?

We understand your time is valuable, and that is why we have a very quick and easy application process. If you feel that this would be the right position for you, please fill out our initial 3-minute, mobile-friendly application. We look forward to meeting you!

ABOUT CASTLE BIOSCIENCES INC.

At Castle, it all comes down to people. After all, disease doesn't just happen - it happens to people. We believe that disease management and treatment decisions can be better informed through a person's unique biology, which is revealed through the scientific rigor of our innovative, laboratory-developed tests. We are committed to empowering healthcare providers and patients with the goal of improved outcomes.

Every employee at Castle has an impact on patient care, and we work to ensure that everyone finds their work to be both challenging and rewarding. We behave with integrity and treat our colleagues with respect and kindness. Our culture fosters an environment of trust, transparency, and collaboration. We prioritize and encourage internal growth and professional development.

Castle Biosciences is an equal opportunity employer as to all protected groups, including protected veterans and individuals with disabilities.

If you have a disability and you believe you need a reasonable accommodation in order to search for a job opening or to submit an online application, please e-mail ReasonableAccommodationsRequest@castlebiosciences.com.

This email was created exclusively to assist disabled job seekers whose disability prevents them from being able to apply online. Only messages left for this purpose will be returned. Messages left for other purposes, such as following up on an application or technical issues not related to a disability, will not receive a response.

** No third-party recruiters, please