Sr. Payer Contracting Analyst
Sr. Payer Contracting Analyst
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Job Description
Help us change lives
At Exact Sciences were helpingchange how the world prevents detects and guides treatment for cancer. We give patients and clinicians the clarity needed to make confident decisions when they matter most. Join our team to find a purpose-driven career an inclusive culture and robust benefits to support your life while youre working to help others.
Position Overview
The Senior Payer Contracting Analyst performs a variety of legal research and process functions on behalf of our family of clinical laboratories to support insurance contracting and other reimbursement initiatives. This position regularly interfaces with leadership team members other employees and teams and third parties with whom the company interacts to gather and exchange information. The function of this role enables the department to optimize our resources to meet our core business demands.
Essential Duties
Include but are not limited to the following:
- Support Market Access Regulatory and Market Strategy team and other market access teams in facilitating the payer contracting process. Assist Market Access Regulatory and Market Strategy team in the build-out and maintenance of payer contracting workflows policies systems and IT solutions.
- Act as a knowledge resource to the market access team regarding current contracting policies and processes.
- Be a connection between market access and the billing and reimbursement teams to conduct analysis of data and trends including the generation of reports related to insurance payer performance. Handle details of a highly confidential critical and time sensitive nature including patient information.
- Work with Market Access Regulatory and Market Strategy team to develop and revise strategy and other efforts related to billing and reimbursement.
- Be able to identify and isolate trends from payer data and use those trends to inform analysis as to future market access strategy.
- Research laws and regulations related to relevant contracting issues including insurance billing and reimbursement in government payer programs and commercial insurance.
- Maintain clear and complete records related to market access efforts to credential and enroll with insurance payers.
- Communicate with insurance companies related to credentialing or billing and reimbursement issues and trends.
- Periodically prepare and review external communications.
- Assist Market Access Regulatory and Market Strategy team in developing presentation materials as requested.
- Perform other related duties as assigned by management.
- Uphold company mission and values through accountability innovation integrity quality and teamwork.
- Support and comply with the companys Quality Management System policies and procedures.
- Maintain regular and reliable attendance.
- Ability to act with an inclusion mindset and model these behaviors for the organization.
- Ability to work on a mobile device tablet or in front of a computer screen and/or perform typing for approximately 90% of a typical working day.
- Ability and means to travel X% between (select one: local Exact Sciences / Madison / Redwood City) locations.
- Ability to travel 5% of working time away from work location may include overnight/weekend travel.
Minimum Qualifications
- High School Diploma or General Education Degree (GED).
- 5 years of experience as a paralegal or other contracting support role for a health care organization (e.g. provider organization insurance company etc.).
- Demonstrated ability to perform the essential duties of the position with or without accommodation.
- Authorization to work in the United States without sponsorship.
Preferred Qualifications
- Bachelors Degree in relevant field as outlined in the essential duties.
- 3 years of experience in insurance contracting support at a health care provider organization.
- Possession of Paralegals Certificate from ABA.
Salary Range:
$89000.00 - $151000.00The annual base salary shown is for this position located in US - WI - Madison on a full-time basis. In addition this position is bonus eligible and is eligible to be considered for company stock at hire and on an annual basis.
Exact Sciences 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 Exact Sciences fosters a culture where all employees can develop 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. All 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.
Required Experience:
Senior IC
Employment Type
Full-Time
