Patient Financial Services Associate II
Posted 2026-05-06
Remote, USA
Full-time
Immediate Start
- Job Description:
- Responsible for the accurate and timely processing of claims, appeals, denials, and statements for Exact Sciences
- Demonstrates medical insurance knowledge by resolving billing discrepancies, eligibility, denials, appeals, and aged unpaid claim follow up
- Communicates insurance information to ancillary departments and ensures appropriate coverage
- Reviews and resolves payor denials, appeals, and claims with no response from the payors
- Independently determines initial or ongoing patient insurance eligibility verification, investigates, and corrects accounts within Epic
- Ability to interact with various insurances and third-party payors accurately and timely
- Research missing or erroneous information on accounts using various portals and other resources
- Review/edit claims and appeals prior to submitting to clearinghouse
- Analyze, research, and resolve claim issues applying federal, state, and payor rules
- Correct rejected claims from the claim’s scrubber, clearinghouse, or payor
- Reviews explanations of payments and completes appropriate steps for all denials
- Investigates payor underpayments
- Follow up with payors via phone on unpaid aging claims
- Conducts self in a professional manner in all interactions with members of the Exact Sciences Clinical Laboratory team, clients, and associates
- Requirements:
- High School Diploma or General Education Degree (GED)
- 2 years of experience in medical billing, claims, and/or insurance processing
- Extensive and current 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 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 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