Shire Jobs

JOB REQUIREMENTS: Help us change lives At Exact Sciences, we\'re 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 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 Exact Sciences. 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 via 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. Essential Duties include but are not limited to the following: Independently determine initial or ongoing patient insurance eligibility verification, investigate, and correct accounts within 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 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. Correct rejected claims from the claim\'s scrubber, clearinghouse, or payor. Review explanations of payments, analyzes, and completes appropriate steps for all denials by appropriately identifying claim resolution next steps; including appealing, writing off, or sending statements. Investigate payor underpayments. Follow up with payors via phone... For full info follow application link. We are an equal employment opportunity employer. All qualified applicants will receive consideration for employment without regard to age, color, creed, disability, gender identity, national origin, protected veteran status, race, religion, sex, sexual orientation, and any other status protected by applicable local, state or federal law. Applicable portions of the Company\'s affirmative action program are available to any applicant or employee for inspection upon request. ***** APPLICATION INSTRUCTIONS: Apply Online: ipc.us/t/5FC70CBD02C24895