Clinical Reimbursement Assistant

Case & Product Support:

• Request and review medical records to identify relevant clinical information (e.g., personal and family history) to support genetic testing cases.
• Flag missing or incomplete documentation for follow-up and assemble documentation packets for prior authorization, claims, or appeals.
• Maintain accurate case documentation within internal systems.

Medical Records Coordination:

• Send and track medical record requests and monitor case pipelines to ensure required documentation is received.
• Update internal systems to reflect record status and next steps, and meet defined daily/weekly task metrics.

Project & Outreach Support:

• Support provider and patient outreach initiatives related to documentation or required forms, and assist with tracking outreach efforts and responses.
• Contribute to internal projects focused on operational improvement and workflow efficiency.

Collaboration & Compliance:

• Collaborate with Genetic Counselors, Prior Authorization, Billing, and Appeals teams, and participate in team meetings and process improvement initiatives.
• Maintain accurate documentation and compliance with HIPAA/PHI standards.