Payer Contracting Senior Analyst

Help us change lives

At Exact Sciences, we’re helping change 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 Payer Contracting Senior 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 company’s 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 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

• Bachelor’s 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 Paralegal’s Certificate from ABA.

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Salary Range:

$85,000.00 - $135,000.00

 

The 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 receive company stock upon hire as well as annually.

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.

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