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Contract Compliance Analyst III
Location
Wisconsin
Posted
123 days ago
Salary
$52K - $86K / year
Seniority
Senior
Job Description
Contract Compliance Analyst III
Exact Sciences
• 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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