Is Clinical Billing Integrity Lead Analyst at GeneDx a remote job?

Yes, Clinical Billing Integrity Lead Analyst at GeneDx is remote, but the employer did not state which countries can apply. Check the listing before applying.

What is the salary for Clinical Billing Integrity Lead Analyst at GeneDx?

The listed pay range for this role is $100k–120k/yr.

Click the "Apply" button on this page to go to the official application at GeneDx.

Back to Jobs

GeneDx

Clinical Billing Integrity Lead Analyst

Develop billing integrity protocols for medical claims

The Clinical Billing Integrity Lead Analyst ensures utilization requests and claim submissions align with payers' medical necessity rules. This role involves applying payer-specific medical necessity criteria.

Why This Role?

Contribute to precision medicine as the standard of care

Key Responsibilities

Apply payer-specific medical necessity criteria
Support utilization requests and claim submissions
Ensure alignment with payers' medical necessity rules

Requirements

Knowledge of medical billing and coding
Understanding of payer-specific medical necessity rules
Analytical skills

Required Skills

data-analysismedical-billingpayer-ruleshealthcareteamworkData AnalysisMedical BillingHealthcare Operations

Indonesia Context

Working Hours Overlap:: Flexible — work your own hours

See remote (USD) vs local pay →

View Original Description from Greenhouse BoardsShow more

Original description from Greenhouse Boards

<span data-ccp-parastyle="paragraph" data-ccp-parastyle-defn="{"ObjectId":"aaed607e-c2a3-5841-9fb4-41037bfa0faf|1","ClassId":1073872969,"Properties":[201342446,"1",201342447,"5",201342448,"1",201342449,"1",469777841,"Times New Roman",469777842,"Times New Roman",469777843,"Times New Roman",469777844,"Times New Roman",201341986,"1",469769226,"Times New Roman",268442635,"24",469775450,"paragraph",201340122,"2",134233614,"true",469778129,"paragraph",335572020,"1",335559740,"240",201341983,"0",134233118,"true",134233117,"true",469778324,"Normal"]}">GeneDx (Nasdaq: WGS) delivers personalized and actionable health insights to inform diagnosis, direct treatment, and improve drug discovery. The company is uniquely positioned to accelerate the use of genomic and large-scale clinical information to enable precision medicine as the standard of care. GeneDx is at the forefront of transforming healthcare through its industry-leading exome and genome testing and interpretation services, fueled by the world’s largest, rare disease data sets. For more information, please visit <a href="http://www.genedx.com/">www.genedx.com</a>.  Summary    The Clinical Billing Integrity Lead Analyst will support the organization’s efforts in ensuring that all utilization requests and claim submissions align to payers' medical necessity rules and requirements. This role includes the application of payer-specific medical necessity criteria to claims and prior authorization requests, ensuring that clinical documentation supports the medical necessity of services provided. The lead analyst will work closely with claims, coding, appeals, billing and other internal clinical teams to ensure adherence to payer policies and regulatory guidelines, mitigating the risk of claim denials and improving success of appeals to ensure accurate reimbursement. This position directly reports to the Associate Director of Clinical Billing Integrity.  Job Responsibilities  <ul> <li data-leveltext="" data-font="Symbol" data-listid="18" data-list-defn-props="{"335552541":1,"335559685":720,"335559991":360,"469769226":"Symbol","469769242":[8226],"469777803":"left","469777804":"","469777815":"hybridMultilevel"}" data-aria-posinset="1" data-aria-level="1">Lead clinical integrity efforts cross-functionally to ensure adherence to medical necessity rules and payer-specific requirements for claims and invoices.  </li> </ul> <ul> <li data-leveltext="" data-font="Symbol" data-listid="18" data-list-defn-props="{"335552541":1,"335559685":720,"335559991":360,"469769226":"Symbol","469769242":[8226],"469777803":"left","469777804":"","469777815":"hybridMultilevel"}" data-aria-posinset="2" data-aria-level="1">Create clinical materials as appropriate including letters of medical necessity, pricing justification and appeal templates   </li> </ul> <ul> <li data-leveltext="" data-font="Symbol" data-listid="18" data-list-defn-props="{"335552541":1,"335559685":720,"335559991":360,"469769226":"Symbol","469769242":[8226],"469777803":"left","469777804":"","469777815":"hybridMultilevel"}" data-aria-posinset="3" data-aria-level="1">Review and decision prior authorization and claims denials for compliance with medical necessity rules, identifying potential issues or discrepancies in clinical documentation and coding, and identifying opportunities for appeals.  </li> </ul> <ul> <li data-leveltext="" data-font="Symbol" data-listid="18" data-list-defn-props="{"335552541":1,"335559685":720,"335559991":360,"469769226":"Symbol","469769242":[8226],"469777803":"left","469777804":"","469777815":"hybridMultilevel"}" data-aria-posinset="4" data-aria-level="1">Create and follow new processes or process changes and to ensure compliance and intended outcomes as needed  </li> </ul> <ul> <li data-leveltext="" data-font="Symbol" data-listid="18" data-list-defn-props="{"335552541":1,"335559685":720,"335559991":360,"469769226":"Symbol","469769242":[8226],"469777803":"left","469777804":"","469777815":"hybridMultilevel"}" data-aria-posinset="5" data-aria-level="1">Integration of new technology and initiatives for summarization of clinical information for both pre-and post-test teams  </li> </ul> <ul> <li data-leveltext="" data-font="Symbol" data-listid="18" data-list-defn-props="{"335552541":1,"335559685":720,"335559991":360,"469769226":"Symbol","469769242":[8226],"469777803":"left","469777804":"","469777815":"hybridMultilevel"}" data-aria-posinset="6" data-aria-level="1">Provide insight into new and emerging use cases for exome and genome sequencing  </li> </ul> <ul> <li data-leveltext="" data-font="Symbol" data-listid="18" data-list-defn-props="{"335552541":1,"335559685":720,"335559991":360,"469769226":"Symbol","469769242":[8226],"469777803":"left","469777804":"","469777815":"hybridMultilevel"}" data-aria-posinset="7" data-aria-level="1">Provide feedback for Market Access on payor specific gaps in coverage and/or misalignment to industry standards  </li> <li data-leveltext="" data-font="Symbol" data-listid="18" data-list-defn-props="{"335552541":1,"335559685":720,"335559991":360,"469769226":"Symbol","469769242":[8226],"469777803":"left","469777804":"","469777815":"hybridMultilevel"}" data-aria-posinset="8" data-aria-level="1">Analyze data trends, using a variety of data visualization tools (e.g. PowerBI, Tableau, Smartsheets) to find new opportunities for targeted expansion of clinical billing integrity team efforts </li> </ul> People Manager  <ul> <li data-leveltext="·" data-font="Courier New" data-listid="11" data-list-defn-props="{"335552541":1,"335559685":1080,"335559991":360,"469769226":"Courier New","469769242":[8226],"469777803":"left","469777804":"·","469777815":"hybridMultilevel"}" data-aria-posinset="1" data-aria-level="1">No  </li> </ul> Education, Experience, and Skills  <ul> <li data-leveltext="·" data-font="Courier New" data-listid="15" data-list-defn-props="{"335552541":1,"335559685":1080,"335559991":360,"469769226":"Courier New","469769242":[8226],"469777803":"left","469777804":"·","469777815":"hybridMultilevel"}" data-aria-posinset="1" data-aria-level="1">Master's Degree in Genetic Counseling or related field  </li> </ul> <ul> <li data-leveltext="·" data-font="Courier New" data-listid="15" data-list-defn-props="{"335552541":1,"335559685":1080,"335559991":360,"469769226":"Courier New","469769242":[8226],"469777803":"left","469777804":"·","469777815":"hybridMultilevel"}" data-aria-posinset="2" data-aria-level="1">Minimum of 3 years of experience, lab and/or payer experience preferred. </li> </ul> <ul> <li data-leveltext="·" data-font="Courier New" data-listid="15" data-list-defn-props="{"335552541":1,"335559685":1080,"335559991":360,"469769226":"Courier New","469769242":[8226],"469777803":"left","469777804":"·","469777815":"hybridMultilevel"}" data-aria-posinset="3" data-aria-level="1">Demonstrated experience in genetic and molecular billing operations and medical necessity criteria. </li> </ul> <ul> <li data-leveltext="·" data-font="Courier New" data-listid="15" data-list-defn-props="{"335552541":1,"335559685":1080,"335559991":360,"469769226":"Courier New","469769242":[8226],"469777803":"left","469777804":"·","469777815":"hybridMultilevel"}" data-aria-posinset="4" data-aria-level="1">Extensive experience with clinical documentation and medical coding (CPT, ICD-10, HCPCS)  </li> </ul> <ul> <li data-leveltext="·" data-font="Courier New" data-listid="15" data-list-defn-props="{"335552541":1,"335559685":1080,"335559991":360,"469769226":"Courier New","469769242":[8226],"469777803":"left","469777804":"·","469777815":"hybridMultilevel"}" data-aria-posinset="5" data-aria-level="1">Experience with Medicare, Medicaid, and Commercial plans preferred. </li> <li data-leveltext="·" data-font="Courier New" data-listid="15" data-list-defn-props="{"335552541":1,"335559685":1080,"335559991":360,"469769226":"Courier New","469769242":[8226],"469777803":"left","469777804":"·","469777815":"hybridMultilevel"}" data-aria-posinset="6" data-aria-level="1">Excellent communication, organizational, and problem-solving skills. </li> </ul> Certificates, Licenses, Registrations  <ul> <li data-leveltext="·" data-font="Courier New" data-listid="16" data-list-defn-props="{"335552541":1,"335559685":1080,"335559991":360,"469769226":"Courier New","469769242":[8226],"469777803":"left","469777804":"·","469777815":"hybridMultilevel"}" data-aria-posinset="1" data-aria-level="1">Certification by the American Board of Genetic Counseling (ABGC) or equivalent </li> <li data-leveltext="·" data-font="Courier New" data-listid="16" data-list-defn-props="{"335552541":1,"335559685":1080,"335559991":360,"469769226":"Courier New","469769242":[8226],"469777803":"left","469777804":"·","469777815":"hybridMultilevel"}" data-aria-posinset="2" data-aria-level="1">Genetic counseling state licensure as required by law. </li> </ul> Work Environment  This is a fully remote position. The employee will work from a home office or other suitable remote location with reliable high-speed internet access. Work is performed in a climate-controlled environment using standard office equipment including computer, phone, and video conferencing tools. Your standard work schedule and hours will be established in collaboration with your leader and may be adjusted to align with evolving business needs.    #LI-REMOTE  <div class="content-pay-transparency"><div class="pay-input"><div class="title">Pay Transparency, Budgeted Range</div><div class="pay-range">$100,000—$120,000 USD</div></div></div><div class="content-conclusion"><div class="column _8-col center-element _12-col-tab"> <div class="margin-bottom margin-24"> <h3 class="heading-l">A culture that plays to win, because patients are counting on us</h3> </div> </div> <div class="column _8-col _12-col-tab"> At GeneDx, we're driven by urgency and purpose: helping patients get diagnosed earlier. Our mission, to empower everyone to live their healthiest life through genomics, drives our team to make a tangible impact each day – and shapes our culture where high standards, strong teamwork, and meaningful ownership are the norm. We act with intention, support one another, and deliver work we're proud to put our names on. Here’s what you can expect day to day: 1. Play like a champion (step up, redefine what’s possible, own it) We bring energy, focus, and a bias for action. We step up, take initiative, and deliver on our commitments – with quality, speed, and care. <div class="card-number">2. Think bigger (stretch beyond, courage not consensus)</div> We push past the obvious. We challenge assumptions, raise the bar, and make thoughtful, decisive calls — choosing progress over perfection. <div class="card-number">3. Grow fast (be curious, speak up, be agile)</div> We stay curious, ask questions, and share direct feedback with respect. We adapt quickly and keep learning through collaboration and continuous improvement. If you’re motivated by meaningful work, a fast-moving environment, and teammates who care deeply about outcomes, you’ll thrive at GeneDx. </div> <div>At GeneDx, we believe in taking care of our people. We provide competitive compensation and benefits that reflect local market practices and legal requirements in each country where we operate, helping employees thrive both professionally and personally.</div> We welcome everyone regardless of their background. All qualified applicants will receive consideration for employment without regard to race, color, religion, national origin, sex, gender, gender identity, sexual orientation, protected veteran status, disability, age, and other characteristics protected by law. GeneDx is a place where people from all backgrounds can make an impact. All privacy policy information can be found <a href="https://www.genedx.com/privacy" target="_blank">here</a>.</div>

Salary Context

Similar Data & Analytics roles on LokerDollar pay around $200k/yr (range $39.5k–404k/yr, n=156 active listings).

Openness not stated by employer — check the listing

Company

GeneDx

Source

Greenhouse Boards

Salary

$100k–120k/yr

Job Type

full time

Location

Remote · Countries not stated

Share this job

Help a friend find their next remote role.

Frequently asked questions

Is Clinical Billing Integrity Lead Analyst at GeneDx a remote job?: Yes, Clinical Billing Integrity Lead Analyst at GeneDx is remote, but the employer did not state which countries can apply. Check the listing before applying.
What is the salary for Clinical Billing Integrity Lead Analyst at GeneDx?: The listed pay range for this role is $100k–120k/yr.
What type of employment is Clinical Billing Integrity Lead Analyst at GeneDx?: This is a full time position.
How do I apply?: Click the "Apply" button on this page to go to the official application at GeneDx.