The Patient Access Specialist (PAS) position is responsible for mentoring, training, and auditing new and existing Patient Access associates.  In this position, the PAS supports the Patient Access team as the subject matter expert on Patient Access workflows and supporting training activities through collaboration with training and development to ensure all team members are properly trained in a consistent manner.  The PAS conducts quality audits to confirm competencies and partners with Revenue Cycle leadership when quality metrics are not successfully met. In addition, the PAS assists in maintaining accurate data reporting practices to ensure consistent and diligent capture of competency.  PAS will partner with members of Revenue Cycle leadership, Lab Training and Development, and Epic teams to help escalate system solutions and training development needs based on key trends identified in the quality review process. 

• Independently determine initial or ongoing patient insurance eligibility verification for all claims, including commercial and government insurance, to the plan coverage level by utilizing various insurances/third party payors portals and contacts.
• Perform audit reviews of accounts for the Patient Access team.
• Stay current with relevant medical billing regulations, rules, and guidelines.
• Ability to use Microsoft software, including Excel, Power Point, and Access Databases, to compile and track performance at an individual and department level.
• Create weekly and monthly audit reports showing details of audits and results.
• Maintain accurate records of training.
• Perform root cause analysis on missed quality goals and identify training trends and needs by assessing overall status of quality data, employee needs, and business needs.
• Assist Training and Development by providing in-class support of new hire training.
• Assist in retraining employees and executing on continued training plans through partnership with Training and Development.
• Collaborate cross-functionally to ensure consistency in training and re-training processes.
• Provide ad-hoc support, as necessary, within the department with special projects, provide support due to outages/high volume, etc.
• Provide coaching and mentorship to Patient Access Associates based on audit outcomes.
• Partner with multiple teams to identify key trends and escalate system solutions or training and development needs.
• Assist in ensuring mentoring consistency by facilitating and leading communication.
• Ability to identify trainee needs and partner to create training programs to meet those needs.
• Maintain a positive attitude with excellent interpersonal skills and the ability to interact and build solid working relationships with peers at all levels of the organization.
• Self-motivated and focused to perform quality work with excellent time management skills and reliability without constant supervision.
• Excellent problem-solving abilities and organizational skills.
• Excellent quantitative and analytical skills.
• Excellent verbal and written English communication skills.
• Ability to communicate effectively with all levels of staff through both verbally and written.
• Ability to work in a team environment and adapt to changing workload and circumstances effectively; able to respond to new information quickly.
• Disciplined, self-motivated, and 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.
• Ability to organize work, set priorities, and work effectively in a diverse environment.
• Maintain strictest confidentiality; adheres to all HIPAA guidelines/regulations.
• Strong attention to detail and focus on quality output.
• 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.
• Regular and reliable attendance.
• Ability to work normal schedule of Monday through Friday during normal business hours.
• Ability to work in front of a computer screen and/or perform typing for approximately 90% of a typical working day.
• You will be required to successfully complete all Epic Certification requirements with a score of 80% or higher. Exact Sciences will make a reasonable accommodation available, if necessary, to assist an employee with a disability to satisfy this requirement.

Minimum Qualifications

• Associates degree in Business, Analytics, Healthcare, or related field; or High School Degree/General Education Diploma and 2 years of relevant experience in lieu of Associates degree.
• 2+ years of experience in medical billing, claims, and/or insurance processing.
• 1+ years of peer-to-peer training/mentoring or education experience in leading and motivating others, even when not in a position of authority.
• Strong knowledge of EHR operating systems involving investigation and correction of accounts; including updates to patient demographics, financial, and guarantor information.
• Proficient in Microsoft Office.
• Proficient computer skills to include Internet navigation, Email usage, and word processing.
• 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

• Associates degree in Business, Analytics, Healthcare, or related field.
• 3+ years of experience in medical or insurance billing field.
• 1+ years of experience with peer-to-peer training or education experience in leading and motivating others, even when not in a position of authority.
• Experience with Epic or other EHR application.
• Experience with adult learners and adult learning theories.
• Medical billing certification.

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.