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Changing the way we think about detecting and treating cancer.
Revenue Cycle Associate II
Location
United States
Posted
15 days ago
Salary
$41.2K - $61.8K / year
Seniority
Mid Level
Job Description
Revenue Cycle Associate II
Exact Sciences
• Responsible for the accurate and timely work of filing insurance claims for Exact Sciences • Independently determine initial or ongoing patient insurance eligibility verification, investigate, and correct accounts within Epic • Ability to interact with various insurances and 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 • Review/edit claims and appeals prior to submitting to clearinghouse • Analyze, research, and resolve claim issues applying federal, state, and payor rules and procedures with a high degree of independence • Monitor WQ’s for claims that need additional research and actions taken to get on to path of resolution • Responsible for CRM support • Correct rejected claims from the claim’s scrubber, clearinghouse, or payor • Review explanations of payments, analyze, and complete appropriate steps for all denials by appropriately identifying claim resolution next steps; including appealing, writing off, or sending statements • Maintain strictest confidentiality; adheres to all HIPAA guidelines/regulations
Job Requirements
- High School Diploma or General Education Degree (GED)
- 1+ years in a revenue cycle role
- 3+ years of experience in medical billing, claims, and/or insurance processing
- Extensive and current working knowledge of government, managed care, and commercial insurances claim submission requirements, reimbursement guidelines, and denial reason codes
- Knowledge of medical terminology and/or health insurance terms
- Knowledge of EHR operating systems and work involving electronic records
- Proficient in computer systems and keyboarding skills
- Demonstrated strong attention to detail and focus on quality output
- Demonstrated ability to perform the Essential Duties of the position with or without accommodation
- Authorization to work in the United States without sponsorship.
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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