Billing Support Specialist II

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 www.genedx.com.

Billing Support Specialist II

Must be available Monday - Friday between 8:00am-8:00pm, EST for an 8-hour shift.

Target start date:  January 13, 2025

Purpose 

We operate with conviction that what is best for our customers (patients, their families and the clinicians, payers and partners who serve them) must be embedded in every aspect of our work. 

At GeneDx we believe:

• Genomic information has broad utility, and every person should have access to their genome delivered expertly, ethically, and responsibly -- to guide health decisions throughout life.
• The transition from hypothesis-based to genome-guided healthcare will improve outcomes for patients and the healthcare system that benefit society as a whole. 
• Genomics will radically transform therapeutic development, bringing better therapies to patients, faster; and patients should control and can direct the use of their genomic information to benefit both themselves and advance scientific understanding that helps others.  

In support of these beliefs, we value: 

• Openness, Accountability, Simplicity, Curiosity, Rigor, Efficiency, Equitability, Integrity, Humility, and Bravery.

Through this value system we aim to revolutionize healthcare and change lives by unlocking the answers from within, bringing better health from genomics to patients around the world. 

More about the role 

We are seeking a detail-oriented and customer-focused Billing Support Specialist to join our team. In this role, you will be responsible for managing client and patient billing inquiries, resolving payment issues, and providing exceptional support to our clients. The ideal candidate will have excellent communication skills, a strong understanding of billing processes, and a passion for helping others.

Essential Duties and Responsibilities

• Provide exceptional customer service to patients and healthcare providers, addressing inquiries and concerns promptly and professionally via phone and email,
• Enter and maintain accurate patient information in systems, ensuring data integrity.
• Review and manage various forms, including medical hold forms and faxes, while handling inbound and outbound queues.
• Investigate and resolve billing discrepancies and disputes efficiently, processing payments, refunds, and adjustments accurately.
• Maintain detailed and accurate records of customer interactions and transactions.
• Collaborate with finance and customer service teams to ensure seamless billing operations and provide customers with information about billing policies, procedures, and payment options.
• Identify opportunities for process improvements and contribute to the enhancement of billing procedures.
• Utilize medical terminology for clear communication with patients and healthcare professionals.
• Analyze and resolve customer concerns effectively by utilizing appropriate resources.
• Address billing inquiries, including benefit investigation and prior authorization questions, from clients and patients.
• Contact clients and insurance companies to obtain necessary information for prior authorization and claim submission.
• Provide client education regarding general billing-related issues as needed.
• Navigate various payor types, including Accountable Care Organizations (ACOs), Cash Pay, Commercial/Private Payors (Regional, National Plans), Medicare (Part A and B Carriers), and Medicaid (Fee for Service, Managed Care organizations).

Supervisory Responsibilities

• This job has no supervisory responsibilities.

Qualifications

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• High school diploma or equivalent; associate or bachelor’s degree in a related fiel