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Posted 12 hours ago
Appeals Specialist
GeneDxAppeals Specialist
Requirements
3-5 years laboratory billing appeals, Insurance and payor policy knowledge, Healthcare regulations and HIPAA, Medical terminology and coding, Medicaid and managed Medicaid appeals, Microsoft Office Suite, Xifin experience a plus, EST hours support
Skills
ExcelHIPAAXifin
About the role
Responsibilities
- Review denied claims and assess appeal potential
- Prepare and submit documented appeals for laboratory services
- Communicate with providers and insurance representatives for supporting records
- Track appeals, follow up on resolution, and maintain billing system records
- Analyze denial trends and recommend process improvements
- Apply payor policies, coding guidelines, and healthcare regulations
- Collaborate with clinical, market access, and insurance teams
Requirements
- 3-5 years of laboratory billing appeals experience
- Strong understanding of insurance policies and payor processes
- Knowledge of healthcare regulations, medical terminology, and coding
- Experience with major insurance plans, Medicaid, and Managed Medicaid
- Familiarity with HIPAA compliance
- Proficiency in Microsoft Office Suite
- Xifin experience preferred
- Ability to support EST hours
About the Company
GeneDx provides personalized health insights through exome and genome testing and interpretation services. The company focuses on genomics and large-scale clinical data to improve diagnosis and treatment.
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GeneDx · Completely Remote
