Utilization Review Manager- Revenue Cycle Management

Overview

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
- Revenue Cycle Management at Variantyx.

The role is responsible for managing the claim denials and appeals for the revenue cycle management team. This position reports to the Director of Revenue Cycle Management.

• Assist in the development of the Claim rejection and denial Workflows and Standard Operation Procedures (SOPs)
• 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

• 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