Job Description

Genetic Counselor Assistant, Benefits Investigation

Inform Diagnostics, a Fulgent Genetics Company, is a nationally recognized diagnostics laboratory focused on anatomic pathology subspecialties including gastrointestinal pathology, dermatopathology, urologic pathology, hematopathology, and breast pathology.

Founded in 2011, our parent entity, Fulgent Genetics, has evolved into a premier, full-service genomic testing company built around a foundational technology platform.

Through our diverse testing menu, Fulgent is focused on transforming patient care in oncology, anatomic pathology, infectious and rare diseases, and reproductive health. We believe that by providing a wide range of effective, flexible testing options in conjunction with best-in-class service and support, we can redefine the way medicine is managed for patients and clinicians alike.

Since integrating with our therapeutic development business, Fulgent is also developing drug candidates for treating a broad range of cancers using a novel nanoencapsulation and targeted therapy platform. By merging our fields of expertise, we aim to become a fully integrated precision medicine company.

Summary of Position

The Genetic Counselor Assistant (GCA) will serve as a key member of the Benefits Investigation division, supporting our licensed genetic counselors. This role supports the genetic counselor, internal benefits investigation team, and external providers to facilitate insurance coverage for NGS testing. The GCA will assist in the review of patient cases, assist with administrative tasks, and coordinate with ordering clinicians and genetic counseling partners to obtain information needed for prior authorization and coverage decisions.

Key Job Elements

• Assist genetic counselors with writing letters of medical necessity.
• Track prior authorization progress and update CRM tickets to reflect approvals or denials.
• Work closely with ordering providers and genetic counseling teams to obtain medical records required by insurers.
• Coordinate referrals with 3rd party vendors for insurances that require pre-test genetic counseling.
• May backup the patient financial coordinators with submitting prior authorizations.
• Works on projects related to denials, pre-authorizations, client requirements, and all others assigned.
• Establishes a strong partnership with Sales and Client Services to improve authorization performance.
• Performs other duties as assigned.

Knowledge/Experience

• Bachelor's degree in biology, genetics and/or a health-related field is required.
• 1+ years of working experience in a clinical and/or laboratory setting is required.
• Previous knowledge of healthcare and insurance regulations, policies and procedures. Familiarity with payer guidelines and genetic testing reimbursement challenges and prior experience in insurance coordination, prior authorization, utilization management, or revenue cycle processes is a plus.
• Ability to work in a fast-paced environment and adaptable to change.
• Must lead by example by modeling our core values and effectively communicate to peer team members.
• In-depth knowledge of healthcare and insurance regulations, policies, and procedures.
• Exceptional analytical and critical-thinking skills, with a focus on problem-solving.
• Excellent communication skills (oral and written) and attention to detail.
• Familiarity with payer guidelines and genetic testing reimbursement challenges.
• Prior experience in insurance coordination, prior authorization, utilization management, or revenue cycle processes.

Supervisory Responsibilities

• None

Reports To

• Genetic Counselor in the Benefits Investigations department

Environment

Fulgent Therapeutics LLC is an Equal Employment Opportunity Employer. The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable qualified individuals with disabilities to perform the essential functions. The term "qualified individual with a disability" means an individual with a disability who, with or without reasonable accommodation, can perform the essential functions of the position.

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