GeneDx (Nasdaq: 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 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. For more information, please visit www.genedx.com.
Summary
The Senior Director, RCM Operations, is responsible for leading and optimizing all aspects of revenue cycle operations, including prior authorization, cash posting, payer correspondence, and denial management. This role ensures compliance, drives operational efficiency, and partners with executive leadership to achieve financial performance goals. The Senior Director will lead strategic initiatives to improve reimbursement outcomes, reduce aging accounts receivable, and implement automation and best practices across the organization.
Job Responsibilities
- Strategic Leadership
- Develop and execute long-term strategies for revenue cycle optimization.
- Collaborate with VP Billing and Reimbursement to align operational goals with organizational objectives and financial targets.
- Identify potential risks to revenue based on payer policies and requirements.
- Operational Oversight
- Direct daily operations for entire revenue cycle from prior authorization, claim submission through claim follow-up, appeals, payment posting and correspondence.
- Prioritize collection and appeals efforts to support revenue collections.
- Identify risks based on payer denials and collaborate with internal stakeholders to remove roadblocks.
- Prepare metrics and data analysis of successes and projects for the RCM team.
- Ensure timely and accurate posting of payments and routing of payer communications.
- Compliance & Risk Management
- Maintain adherence to HIPAA, payer guidelines, and audit requirements.
- Implement and monitor SOPs for compliance across all workflows.
- Create workflows to ensure efficient collections and accounts receivable operations.
- Team Leadership
- Recruit, mentor, and develop high-performing teams.
- Foster a culture of accountability, innovation, and continuous improvement.
- Contribute to overall employee success by evaluating performance on a regular basis and provide effective feedback for growth and improvement.
- Analytics & Reporting
- Analyze payment and denial trends to identify improvement opportunities.
- Provide actionable insights and reporting to senior leadership.
- Technology & Process Improvement
- Drive automation and system enhancements to improve efficiency.
- Champion change management and adoption of new tools and processes.
People Manager
- Yes
Education, Experience, and Skills
- Bachelor’s degree in healthcare administration, business, finance, or related field (Master’s preferred).
- Minimum 10 years of progressive experience in revenue cycle management, with at least 5 years in a senior leadership role.
- Deep knowledge of healthcare billing, payer remittance, and regulatory compliance.
- Proven track record of leading large teams and driving operational improvements.
- Experience with RCM technology platforms and automation tools.
Certificates, Licenses, Registrations
- N/A
Physical Demands
This is a sedentary role requiring prolonged periods of sitting while working at a computer. Physical demands include:
- Sitting for extended periods (up to 8 hours per day)
- Repetitive use of hands and fingers for typing and mouse operation
- Visual acuity for reading computer screens and documents
- Ability to communicate effectively via phone and video calls
- Occasional lifting of up to 10 pounds (office supplies, equipment)
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of this position.
Work Environment
This is a fully remote position. The employee will work from a home office or other suitable remote location with reliable high-speed internet access. Work is performed in a climate-controlled environment using standard office equipment including computer, phone, and video conferencing tools. Your standard work schedule and hours will be established in collaboration with your leader and may be adjusted to align with evolving business needs.
#LI-REMOTE
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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
- High-quality testing: Our laboratory is CLIA certified and CAP accredited and most of our tests are also New York State approved.
- Advanced detection: By interrogating genes for complex 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 leverage our rich internal database for additional interpretation evidence.
- Customized care: Our experts review all 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 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 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 & brave in our execution.
- Communicate directly, with empathy.
- Do what we 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
GeneDx is an Equal Opportunity Employer.
All privacy policy information can be found here.
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What We Do
GeneDx is focused on delivering personalized, actionable insights that improve health outcomes. We sit at the intersection of diagnostics and data science, pairing decades of genomic expertise with an unmatched ability to interpret clinical data at scale. Our exome and genome testing is among the best in the industry. We expect that it will be even more advanced in the future with the help of Centrellis®, our innovative health information platform. Powered by millions of medical records, Centrellis® integrates digital tools with artificial intelligence to ingest and synthesize clinical and genomic data. As a result of our robust test menu, including our exome and genome testing, and the comprehensive insights generated by Centrellis®, we are developing a more complete understanding of complex disease than ever before. This translates to faster diagnosis, more effective treatment plans, and enhanced drug discovery. Our offerings help a whole spectrum of healthcare partners -- clinicians, researchers, health systems, pharmaceutical companies, and payors -- improve patient experiences and advance population health
