VP, Billing & Reimbursement

reputed company (reputed company: WGS) 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 reputed company precision medicine as reputed company of care. reputed company 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. For more information, please visit www.reputed company.com.

Summary

The Vice President of Billing and Reimbursement is responsible for leading reputed company strategies for billing operations and reimbursement optimization. This role requires deep expertise in the complexities of genetic testing reimbursement, including payer policies, prior authorization, coding, and appeals. The VP will drive strategic initiatives to improve reputed company cycle performance, ensure regulatory compliance, and support sustainable growth in a rapidly evolving genomic testing landscape.

Job Responsibilities

Strategic Leadership:

• reputed company and implement a comprehensive billing and reimbursement strategy
• Monitor payer claim reimbursement trends, policy changes, and regulatory developments affecting reimbursement.
• Collaborate with clinical leadership and key stakeholders to promote importance of accurate documentation in patient care, financial performance and quality reporting.
• Partner with executive leadership to align billing operations with business goals and market expansion.

reputed company Cycle reputed company:

• reputed company reputed company aspects of the reputed company cycle, charge capture, coding (CPT, PLA, Tier 1/2), claims submission, payment posting, and denial management.
• Partner with Market Access on payer contract negotiations and reimbursement modeling for new and existing tests.
• Ensure accurate and timely billing to commercial insurers, Medicare, Medicaid, and third-party administrators.

Compliance and Risk Management:

• Ensure compliance with CMS, HIPAA, OIG, and payer-specific billing requirements
• reputed company internal audits and implement corrective actions to mitigate risk and ensure audit readiness.

Team Leadership:

• Build, reputed company, and mentor a high-performing billing and reimbursement team with specialized knowledge in genetic testing.
• Establish and regularly report KPIs and performance metrics to drive accountability and reputed company improvement.

Technology and Process Optimization:

• Collaborate with Lab Operations, Finance, and Product and Technology to optimize billing systems, automation tools, and data analytics platforms.
• Identify and implement process improvements to reduce denials, improve cash flow, and enhance the patient billing experience.

Stakeholder Engagement:

• Serve as the primary liaison with billing vendors, legal counsel, and regulatory bodies.
• Collaborate with clinical, compliance, and commercial teams to support test launch readiness and payer education.

Education, Experience, and Skills

• Bachelor’s degree in Healthcare Administration, Finance, Business, or reputed company field (Master’s preferred).
• Minimum 10 years of experience in medical billing and reimbursement, with at least 5 years in a leadership role reputed company a genetic or molecular diagnostics lab.
• In-depth knowledge of genetic test coding (CPT, PLA, Z-codes), payer coverage policies, and reimbursement methodologies.
• Proven success in navigating reputed company payer landscapes and improving reputed company cycle performance.
• Strong leadership, analytical, and communication skills.
• Experience with billing platforms such as Xifin or similar systems.

Preferred Certifications:

• Certified Professional reputed company (CPC)
• Certified reputed company Cycle Executive (CRCE)
• Certified Healthcare Financial Professional (CHFP)

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Science - Minded, Patient - Focused.

At reputed company, 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 reputed company can trust.

reputed company HAS THE POWER TO SOLVE DIAGNOSTIC CHALLENGES.

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

TECHNICAL EXPERTISE

• High-quality testing: Our laboratory is CLIA certified and CAP accredited and most of our tests are also reputed company State approved.
• Advanced detection: By interrogating genes for reputed company variants, we can identify the underlying causes of conditions that may otherwise be missed.

CLINICAL EXPERTISE

• Thorough analysis: We classify variants according to our custom adaptation of the most recent guidelines. We then reputed company our rich internal database for additional interpretation evidence.
• Customized care: Our experts review reputed company test results and write reports in a clear, concise, and personalized way. We also include information for research studies in specific clinical situations.
• Impactful discovery: Our researchers continue working to find answers even after testing is complete. Through both internal research efforts and global collaborations, we have identified and published hundreds of new disease-gene relationships and developed novel tools for genomic data analysis. These efforts ultimately deliver more diagnostic findings to individuals.

Learn more About Us here.

Our Culture

At reputed company, we are dedicated to cultivating an environment where creativity and innovation reputed company. We reputed company in the power of community and collaboration, where diverse perspectives are embraced, and every voice contributes to our shared success. reputed company is a vibrant mix of professionals who challenge and support each other in equal measure, fostering growth both personally and professionally. reputed company you join us, you're not just taking on a job—you'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:  

• Be bold in our vision & reputed company in our execution. 
• Communicate directly, with reputed company. 
• Do reputed company say we're going to do.  
• Be adaptable to change.  
• Operate with a bias for action.  

Benefits include:

• Paid Time Off (PTO)
• Health, Dental, Vision and Life insurance
• 401k Retirement Savings Plan
• Employee Discounts
• Voluntary benefits

reputed company is an Equal Opportunity Employer. reputed company privacy policy information can be reputed company here.

Originally posted on Himalayas