Exact Sciences

Changing the way we think about detecting and treating cancer.

Contract Compliance Analyst III

ComplianceComplianceFull TimeRemoteTeam 5,001-10,000Since 1995H1B SponsorCompany SiteLinkedIn

Location

Wisconsin

Posted

38 days ago

Salary

$52K - $86K / year

3 yrs expEnglish

Job Description

• Facilitate contract implementation and revenue pull-through activities, both proactive and reactive, with internal and external parties • Ensure the public and private payer reimbursement • Review billing and payment processes for efficiency, timeliness, and compliance with corporate goals, contracts and/or regulations • Facilitate and manage contract implementation for operations • Collaborate with Managed Care to develop and maintain agreements • Develop communication for contracts and collaborate with Field Managed Care team in negotiations • Play a role in developing and maintaining a contract database and contract management system • Collaborate with finance and analytics to identify, analyze, and determine next steps to address negative revenue pull-through scenarios • Develop relationships with billing operations staff and payers to resolve claim adjudication issues • Support execution of pull-through plans to meet revenue recovery goals • Identify revenue opportunities and prioritize plans utilizing key payers

Job Requirements

  • 3+ years of experience in billing/reimbursement, coverage, claims, and appeals
  • Demonstrated understanding of public and private Managed Care payers and reimbursement process
  • Demonstrated understanding of market-related issues, contract basics, product coverage, and pull through rationale
  • Proficient with Excel and Epic or similar database; demonstrated ability to maintain competency levels
  • Demonstrated ability to perform the Essential Duties of the position with or without accommodation

Benefits

  • paid time off (including days for vacation, holidays, volunteering, and personal time)
  • paid leave for parents and caregivers
  • retirement savings plan
  • wellness support
  • health benefits including medical, prescription drug, dental, and vision coverage

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