HHiring Reality
← GeneDx

Clinical Billing Integrity Lead Analyst

GeneDx
Location
Remote
Posted
18 days ago
Department
Commercial
What they actually want (must-haves)
  • Master's Degree in Genetic Counseling or related field
  • Minimum of 3 years of experience, lab and/or payer experience preferred
  • Demonstrated experience in genetic and molecular billing operations and medical necessity criteria
  • Extensive experience with clinical documentation and medical coding (CPT, ICD-10, HCPCS)
  • Experience with Medicare, Medicaid, and Commercial plans preferred
  • Excellent communication, organizational, and problem-solving skills
What the job really is

The Clinical Billing Integrity Lead Analyst at GeneDx is responsible for ensuring that utilization requests and claim submissions meet payer medical necessity rules. This role involves reviewing claims and prior authorization requests, creating clinical materials, and collaborating with various internal teams to improve compliance and reduce claim denials. The analyst will also analyze data trends to enhance billing integrity efforts and provide insights on payer coverage gaps.

Benefits
  • Competitive compensation
  • Benefits that reflect local market practices and legal requirements
Things to weigh
  • Remote position requires reliable high-speed internet access
  • No people management responsibilities
  • Vague details on specific technologies or tools used beyond data visualization
  • Salary range provided, but no specific benefits listed
Job score2.6/5
Benefits1/5
Freshness4/5
Career value4/5
Role clarity4/5
Pay transparency0/5

Applying to GeneDx?

See how your résumé matches this role — and tailor it from what actually gets interviews.