Claims Specialist
Proses klaim laboratorium diagnostik untuk maksimalisasi pengembalian uang
Klaim Specialist bertugas mengelola proses klaim dari awal hingga akhir untuk layanan laboratorium diagnostik. Ini meliputi pengajuan, pengikutan, dan penyelesaian klaim asuransi dengan tepat waktu dan akurat. Tugas ini penting untuk memaksimalkan pengembalian uang, mengurangi penolakan klaim, dan mendukung kesehatan keuangan laboratorium.
Kenapa Menarik?
Tugas ini penting untuk kesehatan keuangan laboratorium, memberikan dampak langsung pada pengembalian uang dan penolakan klaim.
Tanggung Jawab Utama
- Mempersiapkan, meninjau, dan mengajukan klaim untuk layanan laboratorium diagnostik ke pembayar komersial dan pemerintah.
- Menganalisis klaim yang ditolak, mengidentifikasi penyebab, dan mengambil tindakan perbaikan termasuk banding dan pengajuan ulang.
- Mengikuti dan memastikan klaim dikirimkan sesuai dengan pedoman pembayar dan kebijakan laboratorium.
Persyaratan
- Memiliki pengalaman dalam pengelolaan klaim laboratorium diagnostik.
- Memahami pedoman pembayar dan kebijakan laboratorium.
- Mampu menganalisis klaim yang ditolak dan mengambil tindakan perbaikan.
Skills Wajib
Konteks Indonesia
- Overlap Jam Kerja:
- Fleksibel — atur jam kerjamu sendiri
Lihat Deskripsi Asli dari Greenhouse BoardsTampilkan selengkapnya
Deskripsi asli dari Greenhouse Boards
<p><strong><span data-contrast="auto">Summary </span></strong><span data-ccp-props="{"201341983":0,"335559739":0,"335559740":240}"> </span></p> <p><span data-contrast="none">The Claims Specialist is responsible for managing the end-to-end claims process for diagnostic laboratory services, ensuring timely and accurate submission, follow-up, and resolution of insurance claims. This role is critical to maximizing reimbursement, reducing denials, and supporting the financial health of the laboratory.</span> <span data-ccp-props="{"201341983":0,"335559739":0,"335559740":240}"> </span></p> <p><strong><span data-contrast="auto">Job Responsibilities</span></strong><span data-ccp-props="{"201341983":0,"335559739":0,"335559740":240}"> </span></p> <ul> <li data-leveltext="" data-font="Symbol" data-listid="16" 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"><span data-contrast="auto">Claims Submission:</span> <br><span data-contrast="auto">Prepare, review, and submit claims for diagnostic lab services to commercial and government payers, ensuring compliance with payer guidelines and laboratory policies.</span><span data-ccp-props="{"201341983":0,"335559739":0,"335559740":240}"> </span></li> </ul> <ul> <li data-leveltext="" data-font="Symbol" data-listid="16" 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"><span data-contrast="auto">Denial Management:</span> <br><span data-contrast="auto">Analyze denied claims, identify root causes, and initiate corrective actions including appeals and resubmissions.</span><span data-ccp-props="{"201341983":0,"335559739":0,"335559740":240}"> </span></li> </ul> <ul> <li data-leveltext="" data-font="Symbol" data-listid="16" 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"><span data-contrast="auto">Follow-Up:</span> <br><span data-contrast="auto">Proactively follow up on outstanding claims, monitor aging reports, and communicate with payers to resolve issues and expedite payment.</span><span data-ccp-props="{"201341983":0,"335559739":0,"335559740":240}"> </span></li> </ul> <ul> <li data-leveltext="" data-font="Symbol" data-listid="16" 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"><span data-contrast="auto">Documentation:</span> <br><span data-contrast="auto">Maintain accurate records of claim status, correspondence, and payer responses in the billing system.</span><span data-ccp-props="{"201341983":0,"335559739":0,"335559740":240}"> </span></li> </ul> <ul> <li data-leveltext="" data-font="Symbol" data-listid="16" 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"><span data-contrast="auto">Collaboration:</span> <br><span data-contrast="auto">Work closely with prior authorization, billing, and reimbursement teams to resolve complex claims and support cross-functional RCM initiatives.</span><span data-ccp-props="{"201341983":0,"335559739":0,"335559740":240}"> </span></li> </ul> <ul> <li data-leveltext="" data-font="Symbol" data-listid="16" 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"><span data-contrast="auto">Compliance:</span> <br><span data-contrast="auto">Stay current with payer requirements, coding updates (CPT, ICD-10), and regulatory changes affecting laboratory claims.</span><span data-ccp-props="{"201341983":0,"335559739":0,"335559740":240}"> </span></li> </ul> <ul> <li data-leveltext="" data-font="Symbol" data-listid="16" 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"><span data-contrast="auto">Reporting:</span> <br><span data-contrast="auto">Generate and analyze claims performance reports to identify trends, opportunities for process improvement, and support management decision-making.</span><span data-ccp-props="{"201341983":0,"335559739":0,"335559740":240}"> </span></li> </ul> <p> </p> <p><strong><span data-contrast="auto">Education, Experience, and Skills</span></strong> <span data-ccp-props="{"201341983":0,"335559739":0,"335559740":240}"> </span></p> <ul> <li data-leveltext="" data-font="Symbol" data-listid="16" 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"><span data-contrast="none">Associate’s or Bachelor’s degree in healthcare administration, business, or related field (preferred).</span><span data-ccp-props="{"201341983":0,"335559739":0,"335559740":240}"> </span></li> </ul> <ul> <li data-leveltext="" data-font="Symbol" data-listid="16" data-list-defn-props="{"335552541":1,"335559685":720,"335559991":360,"469769226":"Symbol","469769242":[8226],"469777803":"left","469777804":"","469777815":"hybridMultilevel"}" data-aria-posinset="9" data-aria-level="1"><span data-contrast="none">2+ years of experience in medical claims processing, preferably in a diagnostic laboratory or healthcare setting.</span><span data-ccp-props="{"201341983":0,"335559739":0,"335559740":240}"> </span></li> </ul> <ul> <li data-leveltext="" data-font="Symbol" data-listid="16" data-list-defn-props="{"335552541":1,"335559685":720,"335559991":360,"469769226":"Symbol","469769242":[8226],"469777803":"left","469777804":"","469777815":"hybridMultilevel"}" data-aria-posinset="10" data-aria-level="1"><span data-contrast="none">Strong knowledge of insurance billing, payer requirements, and denial management.</span><span data-ccp-props="{"201341983":0,"335559739":0,"335559740":240}"> </span></li> </ul> <ul> <li data-leveltext="" data-font="Symbol" data-listid="16" data-list-defn-props="{"335552541":1,"335559685":720,"335559991":360,"469769226":"Symbol","469769242":[8226],"469777803":"left","469777804":"","469777815":"hybridMultilevel"}" data-aria-posinset="11" data-aria-level="1"><span data-contrast="none">Familiarity with laboratory coding (CPT, ICD-10), EOBs, and remittance advice.</span><span data-ccp-props="{"201341983":0,"335559739":0,"335559740":240}"> </span></li> </ul> <ul> <li data-leveltext="" data-font="Symbol" data-listid="16" data-list-defn-props="{"335552541":1,"335559685":720,"335559991":360,"469769226":"Symbol","469769242":[8226],"469777803":"left","469777804":"","469777815":"hybridMultilevel"}" data-aria-posinset="12" data-aria-level="1"><span data-contrast="none">Proficiency with billing software and Microsoft Office Suite.</span><span data-ccp-props="{"201341983":0,"335559739":0,"335559740":240}"> </span></li> </ul> <ul> <li data-leveltext="" data-font="Symbol" data-listid="16" data-list-defn-props="{"335552541":1,"335559685":720,"335559991":360,"469769226":"Symbol","469769242":[8226],"469777803":"left","469777804":"","469777815":"hybridMultilevel"}" data-aria-posinset="13" data-aria-level="1"><span data-contrast="none">Excellent attention to detail, organizational, and communication skills.</span><span data-ccp-props="{"201341983":0,"335559739":0,"335559740":240}"> </span></li> </ul> <ul> <li data-leveltext="" data-font="Symbol" data-listid="16" data-list-defn-props="{"335552541":1,"335559685":720,"335559991":360,"469769226":"Symbol","469769242":[8226],"469777803":"left","469777804":"","469777815":"hybridMultilevel"}" data-aria-posinset="14" data-aria-level="1"><span data-contrast="none">Ability to work independently and collaboratively in a fast-paced environment.</span><span data-ccp-props="{"201341983":0,"335559739":0,"335559740":240}"> </span></li> </ul> <p> </p> <p><strong><span data-contrast="none">Work Environment</span></strong><span data-ccp-props="{"201341983":0,"335559739":0,"335559740":240}"> </span></p> <p><span data-contrast="none">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.</span> <br><span data-ccp-props="{"335559685":0}"> </span></p> <p><strong><span data-contrast="none">Physical Demands</span></strong><span data-ccp-props="{}"> </span></p> <p><span data-contrast="none">This is a sedentary role requiring prolonged periods of sitting while working at a computer. Physical demands include:</span><span data-ccp-props="{"335559738":240,"335559739":240}"> </span></p> <ul> <li data-leveltext="" data-font="Symbol" data-listid="20" 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"><span data-contrast="none">Sitting for extended periods (up to 8 hours per day)</span><span data-ccp-props="{"335559739":0}"> </span></li> </ul> <ul> <li data-leveltext="" data-font="Symbol" data-listid="20" 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"><span data-contrast="none">Repetitive use of hands and fingers for typing and mouse operation</span><span data-ccp-props="{"335559739":0}"> </span></li> </ul> <ul> <li data-leveltext="" data-font="Symbol" data-listid="20" 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"><span data-contrast="none">Visual acuity for reading computer screens and documents</span><span data-ccp-props="{"335559739":0}"> </span></li> </ul> <ul> <li data-leveltext="" data-font="Symbol" data-listid="20" 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"><span data-contrast="none">Ability to communicate effectively via phone and video calls</span><span data-ccp-props="{"335559739":0}"> </span></li> </ul> <ul> <li data-leveltext="" data-font="Symbol" data-listid="20" 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"><span data-contrast="none">Occasional lifting of up to 10 pounds (office supplies, equipment)</span><span data-ccp-props="{"335559739":0}"> </span></li> </ul> <p><span data-contrast="none">Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of this position.</span> <br> <br><strong><span data-contrast="none">Acknowledgements</span></strong><span data-ccp-props="{"335559738":240,"335559739":240}"> </span></p> <p><span data-contrast="none">The above job description is not intended to be an all-inclusive list of duties and standards of the position. Incumbents will follow any other instructions, and perform any other related duties, as assigned by their supervisor. </span><span data-ccp-props="{"201341983":0,"335559739":180,"335559740":240}"> </span></p> <p> </p> <p><span data-ccp-props="{"201341983":0,"335559739":0,"335559740":240}">#LI-REMOTE</span></p> <p><span data-ccp-props="{"201341983":0,"335559739":0,"335559740":240}"> </span></p><div class="content-pay-transparency"><div class="pay-input"><div class="title">Pay Transparency, Budgeted Range</div><div class="pay-range"><span>$34</span><span class="divider">—</span><span>$37 USD</span></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"> <p>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.<br><br><strong>Here’s what you can expect day to day:</strong><br><br>1. Play like a champion (step up, redefine what’s possible, own it)</p> <p class="text-l">We bring energy, focus, and a bias for action. We step up, take initiative, and deliver on our commitments – with quality, speed, and care.<br><br></p> <div class="card-number">2. Think bigger (stretch beyond, courage not consensus)</div> <p class="text-l">We push past the obvious. We challenge assumptions, raise the bar, and make thoughtful, decisive calls — choosing progress over perfection.<br><br></p> <div class="card-number">3. Grow fast (be curious, speak up, be agile)</div> <p class="text-l">We stay curious, ask questions, and share direct feedback with respect. We adapt quickly and keep learning through collaboration and continuous improvement.<br><br>If you’re motivated by meaningful work, a fast-moving environment, and teammates who care deeply about outcomes, you’ll thrive at GeneDx.</p> </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> <p>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.</p> <p><strong>GeneDx is a place where people from all backgrounds can make an impact.</strong></p> <p><strong><br></strong>All privacy policy information can be found <a href="https://www.genedx.com/privacy" target="_blank">here</a>.</p></div>
Konteks Gaji
Posisi Legal & Compliance serupa di LokerDollar dibayar sekitar $135k/yr (kisaran $60.6k–832k/yr, dari 40 listing aktif).
Konteks pasar
- ESTIMASIEstimasi gaji 15% di bawah median peran serupa $135,000/tahun (n=40 listing bergaji).
- TERVERIFIKASIGeneDx: 26 lowongan dalam 3 bulan terakhir, 26 sepanjang waktu di LokerDollar.
- TERVERIFIKASIPerusahaan pertama kali terlihat 12 Sep 2026.
- TERVERIFIKASILowongan ini pertama kali terlihat 15 Sep 2026.
- TERVERIFIKASITerakhir diverifikasi masih aktif 22 Sep 2026.
Pemberi kerja tidak menyatakan keterbukaan lokasi — cek langsung lowongannya
Pertanyaan yang sering diajukan
- Apakah Claims Specialist di GeneDx bisa dikerjakan remote?
- Ya, Claims Specialist di GeneDx bisa dikerjakan remote, tetapi perusahaan tidak menyebutkan negara mana saja yang boleh melamar. Cek deskripsi lowongan sebelum melamar.
- Jenis pekerjaan apa Claims Specialist di GeneDx?
- Posisi ini adalah pekerjaan full time.
- Bagaimana cara melamar?
- Klik tombol "Lamar" pada halaman ini untuk menuju halaman aplikasi resmi GeneDx.
Jelajahi lebih lanjut
Data & laporan pasar
Riset gaji & permintaan skill dari data lowongan kami sendiri.
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- Remote ≠ Remote: Skill yang Membuka Kerja Global untuk Indonesia (2026)12.891 lowongan remote: skill coding bergaji tertinggi justru paling terkunci untuk pelamar Indonesia. Dataset agregat CC BY 4.0.
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- Laporan Hiring Indonesia: Tech vs Non-TechPermintaan lowongan per bidang dari hitungan agregat — bukan listing per-listing.
- Benchmark Gaji IndonesiaKisaran gaji agregat lintas peran, dengan metodologi dan dataset terbuka.
- Indeks Gaji & Permintaan Kerja Remote untuk IndonesiaBerapa banyak lowongan remote global yang terbuka untuk Indonesia, dan gajinya (USD) per bidang.
- Laporan Kuartalan Pasar Kerja IndonesiaPHK, pendanaan, gaji & skill per kuartal — agregat terbuka.
- Laporan Pasar Remote per PeranLaporan otomatis per kelompok peran — skill, senioritas, perusahaan, gaji.
- Benchmark Gaji Remote GlobalGaji tahunan per bidang & mata uang, plus porsi lowongan terbuka untuk seluruh dunia.
Dari blog kami
- Kesalahan Umum Kerja Remote Gaji DollarHindari 7 kesalahan umum saat cari kerja remote gaji dollar biar aplikasi lo gak langsung masuk trash.
- Tren Skill dan Realita Gaji Remote di September 2026Analisis 5.129 lowongan remote terkini: tren skill AI, dominasi komunikasi, dan realita gaji di tengah pasar yang menuntut spesialisasi.
- AI Skill Premium: Fakta Sept 2026Data lowongan remote USD terbaru menunjukkan skill AI jadi pembeda gaji signifikan. Analisis Loker Dollar September 2026.