Reimbursement, Reimbursement Specialist (Medical Records Focus)(Remote)
Castle Biosciences Earns a Top Workplaces USA Award for the Fourth Consecutive Year! 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 (Medical Records Focus) working remotely from your home office based in the USA, with a start date of 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 (Medical Records Focus), This role is responsible for resolving claim errors, communicating with clinicians and patients regarding medical records and appeals, and providing payers with requested or additional documentation to secure the highest level of reimbursement in a molecular diagnostic laboratory setting. The responsibilities include requesting relevant medical records from clinicians' offices, ensuring appropriate documentation is received, and conducting follow-ups when necessary. Additionally, the role involves reviewing medical records for key details, creating custom medical records and appeal cover letters, and making outbound calls to patients regarding consent and appeal requirements while effectively communicating the reimbursement process. The role also includes reviewing insurance denials, analyzing insurance company medical policies, and submitting customized appeal letters accordingly. This role requires you to utilize your critical thinking skills to extract key data from medical records to support reimbursement of tests on behalf of member, to an insurance company. REQUIRED QUALIFICATIONS
- Minimum Requirements
- Two years of health insurance billing with experience in reviewing medical records, extracting key details, and populating custom medical records submissions to payers.
- Experience resolving claim issues for procedures/test that were denied after pre-approval and claim processing.
- Must have in-depth experience reading and interpreting medical record documents and payer medical policies to ensure the medical documents contain the key "medical necessity" criteria required and meet CMS medical documentation requirements.
- 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 as a medical/healthcare Reimbursement Specialist, with a role with one company.
- Please see the attached success profile for additional roles, responsibilities, and requirements.
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