Exact Sciences
Changing the way we think about detecting and treating cancer.
Contract Compliance Analyst III
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
Related Guides
Related Categories
Related Job Pages
More Compliance Jobs
Compliance38 days ago
Full TimeRemoteTeam 5,001-10,000Since 1904H1B Sponsor
Manager overseeing branch inspection operations for Transamerica Financial Advisors.
Compliance38 days ago
Full TimeRemoteTeam 10,001+Since 1961H1B Sponsor
Director overseeing Insurance Product Compliance for Humana
Compliance38 days ago
Full TimeRemoteTeam 10,001+Since 2010H1B No Sponsor
Director, Global Regulatory Lead managing strategies for cancer treatment development
Senior Product Compliance Manager – Trading & Markets
Kraken Digital Asset ExchangeWe put the power in your hands to buy, sell, and trade digital currency 🌏
Compliance38 days ago
Full TimeRemoteTeam 1,001-5,000Since 2011H1B No Sponsor
Senior Product Compliance Manager ensuring regulatory compliance in trading for Kraken