Supervisor, Authorizations

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 primary responsibility of the RCM Authorizations Supervisor is to manage a team of specialists who submit and ensure timely, accurate completion of those authorization requests. Denied authorizations may be appealed by the specialists.

Supervisors in the Revenue Cycle Management Authorizations team will report to the Manager of their function. Team sizes may vary but are intended to be no greater than 8 full-time employees on a team; teams with more than four employees may have a team lead reporting to the supervisor. This is a full-time position, Monday through Friday, with occasional overtime as needed. Candidates within commuting distance of the Brisbane, California office will need to come to the office on a regular basis; remote candidates will work and collaborate from home.

Responsibilities:

Leadership & Training

• Lead your team by establishing and documenting best practices, setting goals, training and coaching staff, and ensuring best practices are followed.
• You will be the primary trainer on your team, with support from a team lead, if your team size allows for a team lead.
• Weekly 1:1s with each member of your team are required, as are weekly team meetings.
• Encourage teamwork and build camaraderie within your team through effective listening and facilitation.
• Model professionalism and build relationships in your internal and external interactions.
• Ensure timely, complete work by your team to minimize DSO.

Productivity and Quality Work

• Manage staff productivity as a leading indicator of goal attainment.
• Establish and implement prioritization methods for staff in work queues.
• You will be expected to audit your team’s work monthly using a scoring system and provide feedback to them.
• Use experience and expertise to improve upon existing processes, technology and system configurations.

Authorization Submissions

• Prioritize work queues to ensure timely work is balanced among teammates to work the most payable accounts.
• Create authorization requests that may include patient medical records to justify medical necessity for CareDx testing.
• Work with clinicians to obtain any missing medical records.
• Determine the ideal method, documentation and pathway for authorization submission based on the patient’s insurance.
• Use payer websites, or portals, laboratory benefit manager (LBM) portals, or fax to submit the authorization requests.
• Follow up on authorization submissions to ensure timely completion

Authorization Appeals

• When authorization requests are denied, submit appeals to challenge payer decisions.
• Identify approval and denial trends and share best practices. Escalate denial trends to CareDx Revenue Cycle Management leaders, Market
• Access and/or Payer Dispute Resolution.
• Propose solutions and collaborate cross-functionally with the Denials Management Steering Committee.
• Share opportunities to improve upstream work to prevent denials.
• Work with patients when their assistance is needed in the appeal process.
• Work professionally with Revenue Cycle teammates to be responsive to requests that require your assistance.

Qualifications:

• Education: High school diploma or equivalent.
• Experience: Minimum of 3 years of experience in a medical billing or authorization role. Prior experience in a supervisory role is preferred.
• 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.

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 for US Employees 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!
• Please refer to our page to view detailed benefits at https://caredx.com/company/careers

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-vets/disabled, 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. Certain jurisdictions require notice of how we use and protect your personal information. For more information, please read our Privacy Policy

The U.S. EEO posters are available here. 

Note: We do not accept resumes from headhunters, placement agencies, or other suppliers that have not signed a formal agreement with us. 

#LI-Remote