Hybrid Senior Billing Compliance Analyst

at Guardant Health

• Job title: Senior Billing Compliance Analyst
• Job type: Full Time
• Experience level: Senior
• Salary: $79,390 - $109,140 per year
• Degree requirement: Bachelor's Degree
• Location requirements: Hybrid, United States

About the role

• Billing Compliance Auditor ensuring accurate and compliant billing practices for oncology diagnostics at Guardant Health. Conducting audits and collaborating to mitigate risks in a regulated environment.

Responsibilities

• Perform routine and targeted audits of claims, charge capture, coding, and reimbursement activities for molecular/NGS testing
• Validate that CPT/HCPCS codes, modifiers, units, and diagnosis codes are accurate and supported by documentation
• Monitor compliance with Medicare, Medicaid, commercial payer policies, NCCI edits, and LCD/NCD requirements specific to molecular pathology and oncology testing
• Identify root causes of billing errors, patterns of non-compliance, and potential areas of financial or regulatory risk
• Review laboratory reports, requisitions, clinical documentation, and test orders to ensure compliance with billing rules and medical necessity criteria
• Confirm alignment of billed services with laboratory workflows, reporting practices, and test menus
• Prepare detailed audit reports summarizing findings, corrective actions, and compliance risks
• Collaborate with billing leadership to revise SOPs, coding guidelines, and internal controls to prevent errors.

Requirements

• Bachelor’s degree in Healthcare Administration, Medical Billing, Health Information Management, or related field; or equivalent experience
• 5+ years of experience in medical billing, revenue cycle, or compliance auditing preferably in a molecular diagnostics or pathology environment
• Knowledge of CPT, HCPCS, ICD-10, and payer reimbursement policies for laboratory services
• Experience interpreting Medicare LCDs/NCDs, particularly for molecular/NGS testing
• Strong analytical, investigative, and documentation skills
• Ability to work with sensitive information while maintaining confidentiality.

Benefits

• Guardant Health is committed to providing reasonable accommodations in our hiring processes for candidates with disabilities, long-term conditions, mental health conditions, or sincerely held religious beliefs.
• Employee may be required to lift routine office supplies and use office equipment.