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Exact Sciences · 1 day ago

Revenue Cycle Coverage and Claims Associate I

United States

Full-time

Remote

New Grad, Entry Level

$34K/yr - $56K/yr

0+ years exp

Exact Sciences is a company dedicated to changing how the world prevents, detects, and guides treatment for cancer. The Revenue Cycle Coverage and Claims Associate I will be responsible for accurately filing insurance claims and ensuring proper coverage and reimbursement processes while adhering to HIPAA regulations and maintaining confidentiality.

BiotechnologyHealth DiagnosticsManufacturingMedical

No H1B

Responsibilities

Maintain confidentiality and adhere to all HIPAA guidelines/regulations

Determine initial or ongoing patient insurance eligibility verification for all claims, including commercial and government insurance to the plan coverage and product level

Investigate and correct accounts within Epic and other systems/tools, including updates to patient demographics, financial information, and guarantor information

Interact with various insurances/third party payors accurately and timely to ensure authorization is obtained and documented based on internal and external policies and regulations

Research missing or erroneous information on accounts using various portals and other resources, including outreach and identification of unknown payors

Stay current with relevant medical billing regulations, rules, and guidelines

Provide ad-hoc support within the department for special projects and outages/high volume events

Complete position responsibilities within the appropriate time frame while adhering to quality standards

Ability to communicate effectively with all levels of staff through both verbal and written communications

Ability to work in a team environment and adapt to changing workload and circumstances effectively; able to respond to new information quickly

Ability to act in a professional manner in all interactions with members of the Exact Sciences clinical laboratory team, clients, and associates

Ability to work with others in a spirit of teamwork and cooperation

Excellent problem-solving abilities and organizational skills

Disciplined, self-motivated and reliable; able to stay focused on a task and work independently; motivated to perform quality work; diligent about arriving to work on time and completing tasks that are assigned in a timely manner

Possess a positive attitude

Ensure compliance with all Company procedures and guidelines; including, but not limited to, Code of Business Conduct and Ethics

Uphold company mission and values through accountability, innovation, integrity, quality, and teamwork

Support and comply with the company’s Quality Management System policies and procedures

Maintain regular and reliable attendance

Ability to act with an inclusion mindset and model these behaviors for the organization

Ability to work designated schedule

Ability to work overtime, as needed

Ability to work in front of a computer screen and/or perform typing for approximately 90% of a typical working day

You will be required to successfully complete an assessment showing understanding of Exact Sciences Epic processes necessary to the job functions with a score of 80% or higher. Exact Sciences will make a reasonable accommodation available, if necessary, to assist an employee with a disability to satisfy this requirement

Qualification

Insurance claims proceduresElectronic health recordsMedical billing certificationOrder managementMedical terminologyMicrosoft OfficeAttention to detailTeamworkProblem-solvingCommunication skills

Required

High School Diploma or General Education Degree (GED)

3+ months of experience in any healthcare field

Strong knowledge of order management, insurance claims procedures, electronic health record (EHR) operating systems

Basic knowledge of medical terminology and/or health insurance terms

Demonstrated strong attention to detail and focus on quality output

Proficient with electronic health records

Proficient in Microsoft Office programs, such as Word and Outlook

Demonstrated ability to perform the essential duties of the position with or without accommodation

Applicants must be currently authorized to work in country where work will be performed on a full or part-time basis. We are unable to sponsor or take over sponsorship of employment visas at this time