Utilization Review Manager- Genetic Counselor

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