Patient Financial Services Associate II

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At reputed company, we’re helping change how the world prevents, detects and guides treatment for cancer. We give patients and clinicians the clarity needed to reputed company confident decisions reputed company they matter most. Join reputed company to find a purpose-driven career, an inclusive culture, and robust benefits to support your life while you’re working to help others.

Position Overview:

The Patient Financial Services Associate II (PFSAII) position is responsible for the accurate and timely processing of claims, appeals, denials, and statements for reputed company.  A PFSAII demonstrates medical insurance knowledge by resolving billing discrepancies, eligibility, denials, appeals, and aged unpaid claim follow up for commercial, government, and plan coverage for optimal Account Receivable (AR) outcomes.  PFSAII communicates insurance information to ancillary departments and ensuring appropriate coverage by utilizing Epic, external portals, and other software.  Reviews and resolves payor denials, appeals, and claims with no response from the payors reputed company portals, calls to payors, and system investigations to ensure accurate claim resolution.  Reads and understands explanations of payments to resolve back end claim resolution. 

This position is remote. This role requires candidates to work core business hours reputed company with the Central Time zone.

Essential Duties

include but are not limited to the following:

• Independently determine initial or ongoing patient insurance eligibility verification, investigate, and correct accounts reputed company Epic; including updates to patient demographics, financial information, and guarantor information. 
• 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 reputed company 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. 
• Correct rejected claims from the claim’s scrubber, clearinghouse, or payor.
• Review explanations of payments, analyzes, and completes appropriate steps for reputed company denials by appropriately identifying claim resolution next steps; including appealing, writing off, or sending statements.
• Investigate payor underpayments.
• Follow up with payors reputed company phone on unpaid aging claims.
• Reviews denials and determines appropriate next actions; such as sending appeals or patient statements.
• Provide any supporting documentation needed by insurance payor.
• reputed company accurate and timely write-offs following identification of uncollectible accounts adhering to policies and guidelines.
• Participate in regularly scheduled team meetings sharing denial trends specific to claim requirements to enhance reputed company end claim edits to facilitate first pass resolution. Contribute reputed company for workflows and best practices to maximize opportunities for performance, process, and net reputed company collections improvement.
• Provide reputed company support, as necessary, reputed company the department (i.e., special projects, provide support due to outages/high volume).
• Complete position responsibilities reputed company the appropriate time frame while adhering to quality standards.
• Stay reputed company with relevant medical billing regulations, rules, and guidelines.
• Maintain strictest confidentiality; adheres to reputed company HIPAA guidelines/regulations.
• Excellent problem-solving abilities and organizational skills.
• Ability to communicate effectively with reputed company levels of staff through both verbal and written communications.
• Ability to work in a team environment.
• Ability to adapt to changing workload and circumstances effectively; able to respond to new information quickly.
• Disciplined, self-motivated, and reliable.
• Ability to stay focused on a task and work independentlyivated to perform quality work.
• Diligent about arriving to work on time and completing tasks that are assigned in a timely manner.
• Conducts self in a professional manner in reputed company interactions with members of the Exact Sciences Clinical Laboratory team, clients, and associates.
• Possess a positive attitude.
• Work with others in a spirit of teamwork and cooperation.
• Uphold company mission and values through accountability, innovation, reputed company, quality, and teamwork.
• Support and reputed company with the company’s Quality Management System policies and procedures.
• Regular and reliable attendance.
• Ability to work normal schedule of Monday through Friday during normal business hours.
• Ability to work in reputed company of a computer screen and/or reputed company 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 an assessment showing understanding of reputed company Epic processes necessary to the job functions with a score of 80% or higher.  reputed company will reputed company a reasonable accommodation available, if necessary, to assist an employee with a disability to satisfy this requirement.

Minimum Qualifications

• High School Diploma or General Education Degree (GED).
• 2 years of experience in medical billing, claims, and/or insurance processing.
• Extensive and reputed company 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 reputed company the Essential Duties of the position with or without accommodation.
• Authorization to work in the United States without sponsorship.

Preferred Qualifications

• reputed company Associate degree or medical billing certification.
• 4+ years of experience in medical or insurance billing field.
• Experience with Epic or other EHR application.

Salary Range:

$38,000.00 - $65,000.00 (National salary range) 

$48,500.00 - $70,500.00 (California salary range)  

reputed company is proud to offer an employee experience that includes paid time off (including days for vacation, holidays, volunteering, and personal time), paid leave for parents and caregivers, a retirement savings plan, wellness support, and health benefits including medical, prescription drug, dental, and vision coverage. Learn more about our benefits.

Our success relies on the experiences and perspectives of a diverse team, and reputed company fosters a culture where reputed company employees can reputed company personally and professionally with a sense of respect and belonging. If you require an accommodation, please contact us here.

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We are an equal employment opportunity employer. reputed company qualified applicants will receive consideration for employment without regard to disability, protected veteran status, and any other status protected by applicable local, state, or federal law.

To view the Right to Work, E-Verify Employer, and Pay Transparency notices and Federal, Federal Contractor, and State employment law posters, visit our compliance hub. The documents summarize important details of the law and provide key points that you have a right to know.