Associate Director, Denials and Appeals

Associate Director, Denials And Appeals

GeneDx 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.

The Associate Director, Claims And Denials is responsible for leading and optimizing the claims follow-up and denials management functions within the revenue cycle. This role ensures timely resolution of outstanding claims, reduces denial rates, and strengthens payer relationships to improve reimbursement outcomes. The ideal candidate brings 510 years of hands-on experience in medical billing, with a strong background in payer interactions and denial mitigation strategies.

Job Responsibilities

• Lead and manage the claims follow-up and denials team, ensuring productivity and quality standards are met.
• Develop and implement strategies to reduce denials and improve first-pass claim resolution rates.
• Analyze denial trends and collaborate with internal departments to address root causes.
• Serve as a primary liaison with payers to resolve complex claim issues and negotiate resolutions.
• Monitor KPIs related to claims aging, denial rates, and recovery performance; report findings to senior leadership.
• Oversee the development of training programs to enhance team expertise in payer guidelines and denial management.
• Collaborate with compliance and coding teams to ensure accurate claim submissions and adherence to regulatory requirements.
• Support system upgrades and automation initiatives to streamline claims and denials workflows.

People Manager

Education, Experience, and Skills

Physical Demands

Work Environment

Pay Transparency, Budgeted Range

$130,000 - $145,000 USD

Science - Minded, Patient - Focused

At GeneDx, we create, follow, and are informed by cutting-edge science. With over 20 years of expertise in diagnosing rare disorders and diseases, and pioneering work in the identification of new disease-causing genes, our commitment to genetic disease detection, discovery, and diagnosis is based on sound science and is focused on enhancing patient care.

Experts In What Matters Most

With hundreds of genetic counselors, MD / PhD scientists, and clinical and molecular genomics specialists on staff, we are the industry's genetic testing experts and proud of it. We share the same goal as healthcare providers, patients, and families : to provide clear, accurate, and meaningful answers we all can trust.

Sequencing Has The Power To Solve Diagnostic Challenges

From sequencing to reporting and beyond, our technical and clinical experts are providing guidance every step of the way :

Technical Expertise

Clinical Expertise

Our Culture

At GeneDx, we are dedicated to cultivating an environment where creativity and innovation thrive. We believe in the power of community and collaboration, where diverse perspectives are embraced, and every voice contributes to our shared success. Our team is a vibrant mix of professionals who challenge and support each other in equal measure, fostering growth both personally and professionally. When you join us, you're not just taking on a jobyou're joining a movement. A movement that champions curiosity, embraces change, and believes in making an impact, one patient at a time. Cultural principles we live by :

Benefits include :

GeneDx is an Equal Opportunity Employer. All privacy policy information can be found here.