Benefits Investigation Manager
Company: Fulgent Therapeutics
Location: Coppell
Posted on: April 2, 2026
|
|
|
Job Description:
Description About Us 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 Benefits Investigation Manager will oversee our benefits
investigation and prior authorization departments. In this role,
you will be responsible for ensuring patients are provided with
cost estimates, financial options for testing, and ensuring all
applicable testing is submitted for prior authorization. This role
is accountable for authorization approvals and will partner closely
with our internal Genetic Counselors, Client Services and Sales
Team to ensure our clients provide records for medical necessity.
Key Job Elements Plan, direct, and manage supervisors and staff to
ensure timely, accurate, and complete processing of services while
ensuring all quality and production goals are met Tracks KPIs
related to team’s performance, authorization approval rates, and
denial reasons. Presents metrics to senior leadership with
resolutions on how to improve overall company performance. Works
with 3rd party vendors related to benefits investigation to ensure
SLAs and expectations are met. Manage day-to-day operations and
personnel in planning and facilitating efficient insurance
verification services to ensure quality and customer satisfaction.
(i.e., program development, process improvement, etc.) Use
experience and knowledge in end-to-end revenue cycle operations to
serve as a liaison between the client and the service delivery
teams. Demonstrate the ability to understand and articulate client
needs and priorities that align with benefits investigation
services. Be a SME on all billing related process aspects
(including prior authorizations and benefits investigations) to the
service delivery teams. Train the service delivery teams on
answering benefits investigation related questions and work with
marketing to provide educational information for clients and
patients. Develop robust SOPs, processes, and training materials.
Resolve employee relations issues and recommend disciplinary action
when required. Build strategic client relationships that will lead
to long-term partnerships Other related projects and duties as
assigned. Qualifications Knowledge/Experience 10 years of
experience in billing, benefits investigation and/or prior
authorizations. Must have experience in prior authorizations.
Preferably NGS testing. 7 years of experience leading or
supervising billing, benefits investigation and/or prior
authorizations teams. Bachelor’s degree in business administration,
healthcare or related field; or equivalent experience Interpersonal
Skills – The ability to establish oneself as a trusted partner for
counterparts; to effectively communicate and engage with all
stakeholders of the organization, including physician and health
system partners. Knowledge of Revenue Cycle Management functions,
including, but limited to Data Entry, ICD9 Coding, Accounts
Receivable Management, and Remittance Application. Proficient in
Microsoft Office Suite, specifically Word, Excel, and Outlook, and
general working knowledge of Internet for business use. Ability to
work in a fast-paced, deadline driven environment. The role
requires staying up to date with payer and policy changes/updates,
and working collaboratively with the clients, the service delivery
teams, and RCM 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.
Please note that Fulgent (and its affiliated companies, including
Inform Diagnostics and CSI Laboratories) does not accept
unsolicited information and/or resumes from search firms or
agencies for our job postings. Search firms or agencies without an
applicable contract and/or express approval to recruit for the role
in question — that choose to submit a resume or client information
to our career page or to any employee of Fulgent — will not be
eligible for payment of any fee(s), and any associated shared data
will become the property of Fulgent.
Keywords: Fulgent Therapeutics, McKinney , Benefits Investigation Manager, Healthcare , Coppell, Texas