Payer Dispute Resolution Specialist

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.  

We are seeking a highly skilled Payer Dispute Resolution Specialist to join our team. This role plays a crucial part in managing payer disputes, appeals, and legal documentation related to healthcare reimbursement. The ideal candidate possesses excellent written communication skills, meticulous attention to detail, and a strong ability to work independently in a fast-paced environment. 

Responsibilities:

• Legal Research & Documentation  
  • Conduct research on payer disputes, insurance policies, and regulatory requirements.
  • Retrieve and organize relevant documents from multiple databases.
  • Draft legal documents, including appeals and dispute-related filings.
  • Prepare correspondence directed at patients, third parties, and legal entities.
  • Maintain well-structured case files to ensure efficient access to key materials.
• Insurance & Reimbursement Support 
  • Analyze insurance payer policies, dispute procedures, and reimbursement models.
  • Utilize Electronic Health Records (EHR), Electronic Medical Records (EMR), and insurer portals effectively.
• Scheduling & Compliance 
  • Manage deadlines, court hearings, and case-related scheduling.
  • Ensure strict adherence to healthcare regulations and insurance appeal procedures.
  • Identify and implement solutions for claim denials and reimbursement disputes.
• Process Optimization & Team Collaboration 
  • Contribute to broader team efforts by assisting with various legal and administrative tasks.
  • Work independently while maintaining professionalism, confidentiality, and sound judgment.
  • Analyze findings and compile comprehensive reports to support resolution strategies.

Qualifications:

• Education:  
  • Bachelor’s degree required.
  • Paralegal certificate from an ABA-accredited program or equivalent experience (preferred).
• Experience: 
  • 3 years in a healthcare, legal, or insurance-related environment, ideally involving payer disputes, medical billing, or claims processing.
  • Strong understanding of healthcare reimbursement processes and regulatory compliance.
• Technical Skills: 
  • Expert in Microsoft Word, Excel, Outlook, Adobe Acrobat, and database management.
  • Familiarity with insurance provider platforms such as Availty.
• Core Competencies: 
  • Strong problem-solving abilities and analytical skills.
  • Ability to manage multiple priorities and perform under pressure.
  • Excellent verbal and written communication skills.
  • High degree of professionalism, discretion, and attention to detail.

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.

By proceeding with our application and submitting your information, you acknowledge that you have read our U.S. Personnel Privacy Notice and consent to receive email communication from CareDx.

For HR administration purposes, the job title is Legal Specialist (Non Attorney).

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