Job Overview
Location
US - Remote
Job Type
Full-time
Category
Marketing
Date Posted
June 18, 2026
Full Job Description
đź“‹ Description
- • Independently verify patient insurance eligibility and update patient demographics, financial, and guarantor information within Epic system.
- • Research and correct missing or erroneous account information using external portals and resources, including identifying unknown payors.
- • Interact with commercial, government, and managed care insurers to obtain and document authorizations per internal and external policies.
- • Review, edit, and prepare claims and appeals for submission to clearinghouses, ensuring compliance with federal, state, and payor regulations.
- • Analyze and resolve claim denials by determining appropriate next steps including appealing, writing off, or sending statements.
- • Correct rejected claims originating from claim scrubbers, clearinghouses, or payors.
- • Monitor and manage Work Queues (WQs) for claims requiring additional research or action to achieve resolution.
- • Investigate and resolve payor underpayments and follow up on unpaid aging claims via phone.
- • Provide required documentation to insurance payors to support claim adjudication.
- • Perform accurate and timely write-offs of uncollectible accounts in alignment with company policies.
- • Utilize Onbase to process and manage department-specific documents.
- • Provide CRM support for reimbursement operations.
- • Validate new workflows introduced due to product growth and own assigned Work Queues until system functionality is confirmed.
- • Stay current with evolving medical billing regulations, reimbursement guidelines, and denial reason codes.
- • Maintain strict confidentiality and full compliance with HIPAA regulations.
- • Work simultaneously on computer and phone systems using a headset for extended periods.
- • Complete daily tasks within required timeframes while meeting quality standards.
- • Adapt to changing workloads, high-volume periods, and system outages with flexibility and reliability.
- • Demonstrate strong problem-solving, organizational, and attention-to-detail skills in all claim resolution activities.
- • Communicate effectively via verbal and written channels with internal teams and external payors.
- • Work independently with minimal supervision while maintaining discipline, motivation, and punctuality.
- • Uphold Exact Sciences’ mission and values through accountability, integrity, quality, and teamwork.
- • Support and comply with the company’s Quality Management System policies and procedures.
- • Regularly attend work during standard Monday–Friday business hours.
- • Successfully complete an assessment demonstrating understanding of Exact Sciences’ processes.
- • Achieve a minimum score of 80% on Epic system proficiency assessment.
- • Perform typing and computer-based tasks for approximately 90% of the workday.
🎯 Requirements
- • High School Diploma or GED
- • 1+ years in TOQ Associate Level I role
- • 3+ years of experience in medical billing, claims, or insurance processing
- • Extensive knowledge of government, managed care, and commercial insurance claim submission requirements, reimbursement guidelines, and denial codes
- • Proficient in computer systems and keyboarding skills
- • Authorization to work in the United States without sponsorship
🏖️ Benefits
- • Paid time off including 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
- • Bonus eligibility
Skills & Technologies
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About Exact Sciences Corporation
Exact Sciences Corporation develops and commercializes molecular diagnostic tests for early detection and prevention of cancer. The Madison, Wisconsin–based company’s flagship Cologuard and Cologuard Plus assays screen for colorectal cancer using stool-based DNA and biomarker analysis. It also offers the Oncotype DX portfolio to guide breast, prostate and colon cancer therapy decisions, and the multi-cancer blood test FirstSight. Through acquisitions and partnerships, Exact Sciences is building a pipeline of liquid-biopsy tests aimed at lung, pancreatic, liver and other cancers, while providing laboratory services and precision oncology tools to hospitals, physicians and patients worldwide.
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