We are transforming precision medicine.
Variantyx is a technology-driven precision medicine company providing state-of-the-art diagnostic
solutions for the rare genetic disorders and reproductive genetics markets, and treatment optimization in
oncology. Our proprietary whole genome analysis platform allows us to better understand a person’s genetic makeup, leading to unmatched diagnostic capabilities and improved personalized treatment
recommendations.
Role Description:
This is a full-time role for a Utilization Review Manager- Genetic Counselor at Variantyx.
The role is responsible for managing the claim denials and appeals for the revenue cycle
management team.
Responsibilities:
- Assist in the development of the Claim rejection and denial Workflows and Standard Operation Procedures (SOPs)
- Establish appeal protocols or delegate appropriate follow-up
- Develop and maintain templates for appeals
- Assist in the development and maintenance of a Payor Guide for the Company focusing on payor policies for medical necessity.
- Develop and send a monthly revenue cycle management newsletter for the company
- Compile and disseminate reports to demonstrate reimbursement of clients and payors
- Provide direct management to Claim Specialist
- Provide training and support to Prior authorization and Benefits investigation team as needed
- Work with Utilization Review Managers to establish team goals and performance metrics
- Meet regularly with the Utilization Management team to ensure clean claim submissions
- Present eternally and externally regarding billing and reimbursement of genetic testing.
- Seek out training opportunities for yourself and your team
Qualifications and Experience::
- Masters in Genetic Counseling or equivalent training and clinicals experience
- Leadership
- Attention to detail and organization
- At least 1 year of clinical experience in genetics
- Board Certified/Board Eligible Genetic Counselor
