Lead Genetic Testing and Laboratory SME
Employment Information
Report this job
Job expired or something wrong with this job?
Job Description
Genetic Testing & Laboratory SME responsible for clinical authority and rule logic development at Cotiviti. Supporting payment integrity related to genetic testing and laboratory services.
Responsibilities:
- Provide deep expertise in molecular diagnostics (germline and somatic), next-generation sequencing (NGS) and multigene panels, and laboratory billing practices (CPT/HCPCS, PLA codes, stacking)
- Act as the primary clinical partner to CST analysts to translate clinical intent into prepay-editable rule logic
- Lead or co-lead development of Coding Validation (CV) edits, and postpay data-mining concepts across laboratory and genetic testing
- Present rule logic and strategy to payer clients; translate complex genetic testing concepts into clear clinical narratives and financial impact/savings opportunity
Requirements:
- Master’s degree in Genetic Counseling or related field
- Board certification preferred (ABGC or equivalent)
- 6-8+ years in genetic counseling, molecular diagnostics, and/or laboratory utilization management
- Deep knowledge of CPT/HCPCS coding for lab/genetic testing, including NGS panel billing complexity and common billing patterns
- Knowledge of prior authorization and utilization management frameworks as applied to genetic testing and laboratory services
Benefits:
- Health insurance
- Dental insurance
- Vision insurance
- Disability insurance
- Life insurance coverage
- 401(k) savings plans
- Paid family leave
- 9 paid holidays per year
- 17-27 days of Paid Time Off (PTO) per year, depending on specific level and length of service with Cotiviti
Similar Jobs
Lead Generator – Sales Partner
Lead Generator role with Wealth & Living Real Estate identifying and connecting with potential property clients through various outreach methods. Working freelance with flexible hours and a commission-based income.
Lead Generation, Appointment Setter VA – Cold Outreach
Virtual Assistant supporting business development through lead generation and appointment setting. Conducting cold outreach and managing client interactions remotely.
Performance Marketing Manager – Lead Generation
Outbound Marketing & Revenue Lead transforming large datasets into revenue through performance marketing. Writing copy, launching campaigns, and optimizing outbound funnels.
Senior Media Buyer – Lead Generation
Senior Media Buyer at an Australian marketing agency managing Meta ads for lead generation clients. Collaborating with content teams and handling 15-20 client accounts effectively.
SEO, Lead Generation Analyst
SEO & Lead Generation Analyst at FusionHit focused on optimizing websites and supporting digital strategies for lead generation. Collaborating across teams to enhance online visibility and engagement.
Lead Generator – Bid Specialist
Lead Generator & Bid Specialist for BCD Travel preparing RFIs, RFPs, RFQs responses. Managing proposal development and ensuring timely submissions while collaborating with EMEA sales teams.
Project Coordination, Lead Generation Virtual Assistant
Virtual Assistant providing project coordination and lead generation support for a home renovation and design company. Managing tasks, documentation, and client communication while assisting in lead generation.
Lead Generation Representative – Tele-sales, Appointment Setting
Lead Generation Representative in charge of identifying sales opportunities and supporting Field Sales team. Contributing to software and digital communications growth through B2B lead generation efforts.
Project Developer – Acquisition, Hamburg
Project Developer managing wind energy project development, negotiations, and external partner coordination. Engaging with local communities, stakeholders, and ensuring project compliance in Hamburg area.
Project Developer — Land Acquisition, Ruhr Area
Real Estate Developer negotiating and managing land contracts for renewable energy in Ruhrgebiet. Engaging with communities and oversight of contracts and properties in a sustainable environment.
Project Developer - Acquisition, m/f/d
Project Developer negotiating land contracts for renewable energy solutions. Engaging communities and managing contracts with a focus on sustainable practices.
Prospecting Support Virtual Assistant – Sales Support
Prospecting Support Virtual Assistant supporting NYC-based sales team with outbound prospecting and lead management. Ideal for organized and detail-oriented candidates.
Outreach and Lead Generation Specialist
B2B Outreach & Lead Generation Specialist focused on LinkedIn and email outreach. Building outbound pipelines and engaging prospects through structured campaigns in a remote role.
Lead Generation Associate
Lead Generation Associate at StartupBlink identifying new opportunities for startup ecosystem growth. Engaging with governments and organizations globally to enhance partnerships and pipeline.
Lead Generation Representative – Launchpad, Saleium
Lead Generation Representative at ChainGPT focused on outbound lead generation for Launchpad and Saleium products. Engaging Web3 projects and ensuring lead qualification for business development support.
Lead Generation Representative – Launchpad, Saleium
Lead Generation Representative for ChainGPT driving pipeline for Launchpad and Saleium. Focused on engaging high-potential Web3 projects needing token launch and fundraising infrastructure.
Lead Generation Representative, Launchpad – Saleium
Lead Generation Representative driving the pipeline for ChainGPT's Launchpad and Saleium products. Engage high-potential Web3 projects to qualify opportunities and support business development efforts.
B2B Prospecting & Appointment Specialist – Direct Mail Marketing
B2B Prospecting Virtual Assistant performing outbound calls to small business owners for direct mail marketing. Seeking qualified appointments with service-based industries, focusing on meaningful conversations.
B2B Prospecting & Appointment Specialist – Direct Mail Marketing
B2B Prospecting Specialist conducting outbound calls to small business owners promoting direct mail marketing services. Seeking experienced individual resilient in high-rejection environments for appointment scheduling.
Lead Generation, Corporate Outreach Specialist
Corporate Outreach Specialist for a short-term rental company. Building partnerships with corporations for housing solutions in Kentucky.