Claims Specialist

Responsibilities

• Prepare, review, and submit claims for diagnostic lab services to commercial and government payers
• Analyze denied claims, identify root causes, and initiate corrective actions including appeals
• Proactively follow up on outstanding claims and monitor aging reports
• Maintain accurate records of claim status and payer responses in the billing system
• Collaborate with prior authorization, billing, and reimbursement teams
• Stay current with payer requirements and coding updates (CPT, ICD-10)
• Generate and analyze claims performance reports to identify trends

Requirements

• Associate's or Bachelor's degree in healthcare administration, business, or related field (preferred)
• 2+ years of experience in medical claims processing, preferably in a diagnostic laboratory
• Strong knowledge of insurance billing, payer requirements, and denial management
• Familiarity with laboratory coding (CPT, ICD-10), EOBs, and remittance advice
• Proficiency with billing software and Microsoft Office Suite

About the Company

GeneDx is driven by the mission to empower everyone to live their healthiest life through genomics, helping patients get diagnosed earlier through high standards and strong teamwork.