Remote Appeals Specialist - Denials & Reimbursement

Socket.dev; United States; On-site; USD 64,000 - 70,000; Full time

Benefits offered by this job

Remote work

Job summary

GeneDx, a leading genomic testing company, is seeking an Appeals Specialist to review denied claims and maximize reimbursement for specialized laboratory services. This fully remote role requires deep knowledge of insurance markets, payor policies, HIPAA, and Medicaid managed care.

You will collaborate with clinical and market access teams, analyze denial trends, and ensure accurate documentation and timely appeals.

Qualifications

• 3–5 years of experience in laboratory billing appeals.
• Strong understanding of insurance policies, healthcare regulations, coding.
• Experience with Medicaid and Managed Medicaid.

Responsibilities

• Review denied claims to determine basis for denial and appeal potential.
• Gather documentation from providers and insurers for appeals.
• Submit payor-required docs with each appeal and track in billing system.
• Monitor follow-ups to ensure timely resolution.
• Ensure compliance with payor policies and coding guidelines.
• Collaborate with clinical teams to resolve appeals issues.

Skills

Attention to detail

HIPAA knowledge

Communication with payors

Time management

Remote collaboration

Tools

Xifin

Billing systems

Job description

GeneDx, a leading genomic testing company, is seeking an Appeals Specialist to review denied claims and maximize reimbursement for specialized laboratory services. This fully remote role requires deep knowledge of insurance markets, payor policies, HIPAA, and Medicaid managed care.

You will collaborate with clinical and market access teams, analyze denial trends, and ensure accurate documentation and timely appeals.