Revenue Cycle Associate II

This is a fully remote position, open to applicants in United States.

📋 Description

• Accountable for the precise and prompt submission of insurance claims for Exact Sciences.

• Independently assess initial or ongoing patient insurance eligibility verification, investigate, and rectify accounts within Epic.

• Capable of engaging with various insurance companies and third-party payors in an accurate and timely manner to ensure authorization is obtained and documented in accordance with internal and external policies and regulations.

• Investigate missing or incorrect information on accounts using a variety of portals and resources, including outreach to identify unknown payors.

• Review and edit claims and appeals before submission to the clearinghouse.

• Analyze, research, and resolve claim issues while applying federal, state, and payor rules and procedures with a high level of independence.

• Monitor work queues for claims requiring further research and actions to facilitate resolution.

• Responsible for providing CRM support.

• Correct rejected claims identified by the claims scrubber, clearinghouse, or payor.

• Review explanations of payments, analyze them, and take appropriate actions for all denials by accurately identifying the next steps for claim resolution, including appealing, writing off, or issuing statements.

• Maintain the highest level of confidentiality; comply with all HIPAA guidelines and regulations.

⛳️ Requirements

• High School Diploma or General Education Degree (GED) required.

• At least 1 year of experience in a revenue cycle role.

• A minimum of 3 years of experience in medical billing, claims, and/or insurance processing.

• Comprehensive and up-to-date knowledge of government, managed care, and commercial insurance claim submission requirements, reimbursement guidelines, and denial reason codes.

• Familiarity with medical terminology and/or health insurance terminology.

• Understanding of EHR operating systems and experience with electronic records.

• Proficient in computer systems with strong keyboarding skills.

• Proven attention to detail and commitment to high-quality output.

• 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 vacation days, 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.