Top 40 Genedx Jobs | SimplyHired

Payment Integrity Specialist
GeneDx —Gaithersburg, MD
- $70,000 - $86,000 a year
- Remote
- Mid-level
- 3 years
- Finance
4d
MSL Support and Clinician Engagement (West)
GeneDx —Portland, OR
- $75,000 - $89,000 a year
- Remote
- Mid-level
- Bachelor's degree
- Continuous improvement
GeneDx Software Engineer -- Lab Informatics
GeneDx, Inc —Gaithersburg, MD
- Full-time
- Computer science
- Computer Science
- Bachelor of Science
- Paid jury duty
- Health savings account
Quick Apply
Appeals Specialist
GeneDx —Gaithersburg, MD
- $31.25 - $33.65 an hour
- Remote
- Microsoft Excel
- Microsoft Outlook
- HIPAA
4d
Product Developement Specialist, GeneDx
GeneDx, Inc —Gaithersburg, MD
- Mid-level
- Master's degree
- Bachelor's degree
Quick Apply
Senior Director, Clinical Programs
GeneDx —Gaithersburg, MD
- $250,000 - $270,000 a year
- Remote
- Medicine
- 5 years
- Public speaking
Regional Account Executive - General Pediatrics (IL/MO)
GeneDx —St. Louis, MO
- $125,000 - $140,000 a year
- Weekends as needed
- Driver's License
- Bachelor's degree
- Travel
Next Generation Sequencing Lab Manager, GeneDx
GeneDx, Inc —Gaithersburg, MD
- Full-time
- Bachelor of Science
- Supervising experience
- Bachelor's degree
Quick Apply
RCM Insurance Claims Manager
GeneDx —Gaithersburg, MD
- $113,000 - $136,000 a year
- Remote
- 5 years
- HIPAA
- Finance
3d
Medical Science Liaison I, Health Systems(West)
GeneDx —Denver, CO
- $150,000 - $165,000 a year
- Remote
- Public speaking
- Mid-level
- Master's degree
Medical Science Liaison I, Specialties(Mid-Atlantic)
GeneDx —Philadelphia, PA
- $150,000 - $165,000 a year
- Remote
- Public speaking
- Mid-level
- Master's degree
13d
Regional Account Executive - Prenatal (Mountain Desert)
GeneDx —Salt Lake City, UT
- $130,000 - $150,000 a year
- Weekends as needed
- Driver's License
- Bachelor's degree
- Travel
Regional Account Executive - General Pediatrics (IL/MO)
GeneDx —Chicago, IL
- $125,000 - $140,000 a year
- Weekends as needed
- Driver's License
- Bachelor's degree
- Travel
Senior Clinical Scientist
GeneDx, Inc —Gaithersburg, MD
- Full-time
- Medicine
- Research
- 3 years
- Paid jury duty
- Health savings account
Quick Apply
Clinical Assistant Director
GeneDx, Inc —Gaithersburg, MD
- Full-time
- Mid-level
- 2 years
- Communication skills
Quick Apply
Senior Software Engineer
GeneDx —New York, NY
- $170,000 - $180,000 a year
- Weekends as needed
- Remote
- Azure
- 3 years
- Java
Account Manager - Speciality Sales
GeneDx —Philadelphia, PA
- $110,000 - $135,000 a year
- Weekends as needed
- Mid-level
- 3 years
- Driver's License
13d
Strategic Account Director - NICU (NYC)
GeneDx —New York, NY
- $170,000 - $190,000 a year
- Weekends as needed
- Hybrid work
- Hospital
- 5 years
- Office
Regional Account Executive - Specialty (Virginia)
GeneDx —Richmond, VA
- $125,000 - $140,000 a year
- Weekends as needed
- Driver's License
- Bachelor's degree
- Travel
Specialty Regional Account Executive (Houston)
GeneDx —Houston, TX
- $125,000 - $140,000 a year
- Weekends as needed
- Remote
- Mid-level
- Master's degree
- Driver's License

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Payment Integrity Specialist

GeneDx -
Gaithersburg, MD

Apply Now

Job Details

$70,000 - $86,000 a year
4 days ago

Qualifications

Medical claims processing software

Full Job Description

Summary

The Payment Integrity Specialist plays a critical role in ensuring accurate reimbursement and regulatory compliance across payer relationships. This position is responsible for monitoring audits and refund requests, auditing payments against payer contracts, and ensuring adherence to Most Favored Nation (MFN) laws. The specialist will collaborate cross-functionally with billing, appeals, finance, and compliance teams to identify discrepancies, mitigate risks, and optimize revenue integrity.

Job Responsibilities

Audit Oversight

Monitor internal and external audits related to claims, payments, and refunds.

Conduct periodic audits of payer contracts and payment activity to ensure compliance with MFN laws and contractual terms.

Identify and escalate discrepancies in payment rates, coding, and authorization processes.

Refund and Payment Reconciliation

Review and process refund requests from payers and patients.

Ensure timely and accurate posting of payments and resolution of denials.

Maintain detailed records of transactions and audit findings.

Contract Compliance

Validate that payments align with negotiated payer contracts and MFN provisions.

Collaborate with legal and contracting teams to interpret and apply MFN rules.

Support payer configuration reviews and contract audits.

Regulatory Adherence

Stay current on federal and state regulations impacting payment integrity, including MFN laws.

Ensure audit processes and documentation meet compliance standards.

Assist in preparing responses to regulatory inquiries and payer audits.

Cross-Functional Collaboration

Partner with appeals, credentialing, and market access teams to resolve payment issues.

Provide feedback and process improvement recommendations to operational teams.

Participate in payer meetings and internal workgroups to enhance audit and payment workflows.

Education, Experience, and Skills

Bachelor's degree in healthcare administration, finance, or related field (or equivalent experience).

3–5 years of experience in medical billing, payment integrity, or payer contract auditing.

Strong understanding of MFN laws, payer policies, and healthcare reimbursement models.

Proficiency in claims management systems and data analytics tools.

Exceptional attention to detail, analytical thinking, and problem-solving skills.

Excellent communication and documentation abilities.

CPCS or similar certification preferred.

#LI-REMOTE

A culture that plays to win, because patients are counting on us

At GeneDx, we're driven by urgency and purpose: helping patients get diagnosed earlier. Our mission, to empower everyone to live their healthiest life through genomics, drives our team to make a tangible impact each day – and shapes our culture where high standards, strong teamwork, and meaningful ownership are the norm. We act with intention, support one another, and deliver work we're proud to put our names on.

Here's what you can expect day to day:

1. Play like a champion (step up, redefine what's possible, own it)

We bring energy, focus, and a bias for action. We step up, take initiative, and deliver on our commitments – with quality, speed, and care.

2. Think bigger (stretch beyond, courage not consensus)

We push past the obvious. We challenge assumptions, raise the bar, and make thoughtful, decisive calls — choosing progress over perfection.

3. Grow fast (be curious, speak up, be agile)

We stay curious, ask questions, and share direct feedback with respect. We adapt quickly and keep learning through collaboration and continuous improvement.

If you're motivated by meaningful work, a fast-moving environment, and teammates who care deeply about outcomes, you'll thrive at GeneDx.

At GeneDx, we believe in taking care of our people. We provide competitive compensation and benefits that reflect local market practices and legal requirements in each country where we operate, helping employees thrive both professionally and personally.

We welcome everyone regardless of their background. All qualified applicants will receive consideration for employment without regard to race, color, religion, national origin, sex, gender, gender identity, sexual orientation, protected veteran status, disability, age, and other characteristics protected by law.

GeneDx is a place where people from all backgrounds can make an impact.

All privacy policy information can be found here.

Apply Now

Refine Your Search

genedx jobs

Payment Integrity Specialist

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Regional Account Executive - General Pediatrics (IL/MO)

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Senior Software Engineer

Account Manager - Speciality Sales

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A culture that plays to win, because patients are counting on us

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