Revenue Cycle Systems and Analytics Lead

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 Revenue Cycle Systems and Analytics Lead is responsible for leading the Revenue Cycle Systems teams in collaboration with team leadership. The Revenue Cycle Systems and Analytics Lead will support the team through continuous process improvement both within the internal Systems team and throughout RCT operations as a whole. This position will also be responsible for leading/developing trainings on new technologies and or workflow processes that will be available to the Systems team in a clear professional manner.  The Revenue Cycle Systems and Analytics Lead will facilitate contract implementation and revenue pull-through activities, both proactive and reactive, with internal and external parties as needed. This position will ensure billing and payment processes are efficient, timely, and in compliance with corporate goals, contracts and/or regulations. This position is designed to be highly cross-functional and is a “working” Lead position with expectations of working alongside staff as well as provide direction.

Essential Duties

include but are not limited to the following:

• Coach, mentor, and engage team members to increase overall performance.
• Responsible for oversight of daily activities as they relate to the Revenue Cycle Teams.
• Drive operational excellence of order entry and exception handling processes; including process flow, data integrity, information alignment, and continual process improvement.
• Support and occasionally co-lead cross-functional initiatives across multiple departments.
• Act as a liaison between other functional areas within Exact Sciences Laboratories.
• Collaborate with team leadership and support the day-to-day team operations.
• Attend train the trainer trainings and be the team facilitator for upcoming workflow enhancements.
• Support team training process and development.
• Facilitate contracts through the contracting process; including reviewing documents, obtaining all information necessary to successfully implement the contract, communicating and working with appropriate parties needed for all relevant systems.
• Develop communication for contracts, amendments, and notifications for the internal Revenue Cycle Team (RCT) customers and collaborate with the Field Managed Care team for operational optimization.
• Act as Subject Matter expert and assist in educating team on system(s), workflows and guidelines.
• Follow-up and investigate any errors/issue and work with respective team members/supervisors for resolution.
• Suggest billing process/workflow updates/changes as necessary.
• Play a role in the development and maintenance of a contract database and contract management system, working with the credentialing and legal teams.
• Collaborate with finance and analytics to identify, analyze, and determine next steps to address negative revenue pull-through scenarios specific to payers and across payer segments, including Medicare Advantage, Blues, Medicaid, etc.
• Collaborate with RCT Managers to develop and leverage relationships with billing operations staff and payers when resolving claim adjudication issues, both contractual and non-contractual.
• Support execution of pull-through plans to meet quarterly revenue goals.
• Facilitate conversations with appropriate Exact personnel early in the contracting process to provide an overview of the account to avoid delay in implementation down the road.
• Maintain professional relationship with vendors; including, attending regular meetings, email communication, and troubleshooting.
• Perform ad-hoc audits as needed.
• Disciplined, self-motivated, and reliable.
• Strong attention to detail and organizational skills.
• Strong analytical skills.
• Ability to drive to results with a high emphasis on quality.
• Ability to present recommendations supported by analytical evaluations.
• Ability to prioritize and multi-task.
• Ability to integrate and apply feedback in a professional manner.
• Disciplined, self-motivated & reliable; able to stay focused on a task and work independently; motivated to perform quality work; diligent about arriving to work on time and completing tasks that are assigned in a timely manner.
• Excellent communication, both written and verbal, across internal and external personnel.
• Ability to collaborate and work effectively as a team member.
• Keeps supervisor(s) informed of any work problems and issues.
• Handle escalated matters prior to Supervisor involvement.
• 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.
• 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 work on a computer and phone simultaneously.
• Ability to use a telephone through a headset.
• You must maintain all certification requirements as deemed necessary.

Minimum Qualifications

• Bachelor’s degree in Business Administration, Finance, or field related to job duties; or High School Degree/General Education Diploma and 4 years of relevant experience as outlined in the essential duties in lieu of Bachelor’s degree.
• 3+ years of experience in billing/reimbursement, coverage, claims, and appeals.
• 2+ years of experience directly or indirectly leading others.
• Demonstrated understanding of public and private Managed Care payers and reimbursement process.
• Demonstrated understanding of market-related issues, contract basics, product coverage, and pull through rationale.
• Proficient with Excel and Epic or similar database; demonstrated ability to maintain competency levels.
• 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

• Knowledge of and/or experience with government Managed Care payers.
• Knowledge of billing and coding.
• Knowledge of PB Resolute or Prelude functionalities in Epic.

Salary Range:

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.

Not ready to apply? Join our talent community and stay up to date on what’s new at Exact Sciences.

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. Any applicant or employee may request to view applicable portions of the company’s affirmative action program.

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.