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Accounts Receivable Specialist

• US – Remote
• Full time
• R23-2230

Position Overview

The Accounts Receivable Specialist will facilitate contract implementation and revenue pull-through activities, both proactive and reactive, with internal and external parties. This position will ensure the public and private payer reimbursement. The role is also fundamental in reviewing that billing and payment processes are efficient, timely, and in compliance with corporate goals, contracts and/or regulations. This position will facilitate and manage contract implementation for operations and partner with Market Access to develop and maintain agreements that provide medical providers and patients with access to our assays while aligning with Exact Sciences goals and objectives.

Essential Duties

include but are not limited to the following:

• Develop communication for contracts, amendments, and notifications for the internal Revenue Cycle Team (RCT) customers and collaborate with the Field Managed Care team in negotiations with payers for operational optimization.
• Play a role in the development and maintenance of a contract database and contract management system, working with the credentialing and legal teams.
• Collaborate with finance and analytics to identify, analyze, and determine next steps to address negative revenue pull-through scenarios specific to payers and across payer segments, including Medicare Advantage, Blues, Medicaid, etc.
• Collaborate with RCT Managers and specialists to develop and leverage relationships with billing operations staff and payers when resolving claim adjudication issues, both contractual and non-contractual.
• Support execution of pull-through plans to meet quarterly/annual revenue recovery goals.
• Identify broad revenue opportunities that span a particular customer segment; including utilizing Content Management Systems (CMS) for noncontracted Managed Medicare non-payments and the Employer Coalition initiative.
• Consistently identify opportunities to recover revenue.
• Collaborate with the Market Access team to identify and prioritize plan(s) utilizing key payers for targeted efforts to impact coverage policy decisions.
• Facilitate conversations with appropriate Exact personnel early in the contracting process to provide an overview of the account to avoid delay in implementation down the road.
• Strong attention to detail and organizational skills.
• Strong analytical skills.
• Ability to drive to results with a high emphasis on quality.
• Ability to present recommendations supported by analytical evaluations.
• Ability to track and maintain records.
• Strong ability to prioritize and multi-task.
• Ability to integrate and apply feedback in a professional manner.
• Excellent communication, both written and verbal, across internal and external personnel.
• Ability to collaborate and work effectively as a team member.
• Uphold company mission and values through accountability, innovation, integrity, quality, and teamwork.
• Support and comply with the System and Analytic team’s policies and procedures.
• Regular and reliable attendance.
• Ability to work on a mobile device, tablet, or in front of a computer screen and/or perform typing for approximately 90% of a typical working day.
• Ability to work on a computer and phone simultaneously.
• Ability to use a telephone through a headset.
• You will be required to successfully complete all Epic Certification requirements with a score of 80% or higher. Exact Sciences will make reasonable accommodation available, if necessary, to assist an employee with a disability to satisfy this requirement.

Minimum Qualifications

• Bachelor’s degree in Business Administration, Finance, or field related to job duties; or High School Degree/General Education Diploma and 4 years of relevant experience as outlined in the essential duties in lieu of Bachelor’s degree.
• 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; demonstrated ability to maintain competency levels.
• Demonstrated ability to perform the Essential Duties of the position with or without accommodation.
• Authorization to work in the United States without sponsorship.

Preferred Qualifications

• Knowledge of and/or experience with government Managed Care payers.
• Knowledge of billing and coding.
• Knowledge of Tableau.

Salary Range:

$59,000.00 – $95,000.00

The annual base salary shown is a national range for this position on a full-time basis and may differ by hiring location. In addition, this position is bonus eligible, and is eligible to receive company stock upon hire as well as annually. Benefits offered include a retirement savings plan, paid vacation, holiday and personal days, paid caregiver/parental leave, and health benefits to include medical, prescription drug, dental and vision coverage in accordance with the terms, conditions, and eligibility requirements of the applicable plans.

If you need any assistance seeking a job opportunity at Exact Sciences, or if you may require a reasonable accommodation with the application process, please email [email protected].

We are an equal employment opportunity employer. All qualified applicants will receive consideration for employment without regard to age, color, creed, disability, gender identity, national origin, protected veteran status, race, religion, sex, sexual orientation, and any other status protected by applicable local, state or federal law. Applicable portions of the Company’s affirmative action program are available to any applicant or employee for inspection upon request.