Contract Compliance Analyst III
Exact Sciences
full-time
Posted on:
Location Type: Remote
Location: Wisconsin • United States
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Salary
💰 $52,000 - $86,000 per year
About the role
- 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
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
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
billingreimbursementclaimsappealscontract managementdata analysisrevenue recoverycontract implementationcommunication developmentnegotiation
Soft Skills
collaborationrelationship buildingproblem solvingorganizational skillsattention to detail