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JOB REQUIREMENTS: Help us change lives At Exact Sciences, we\'re helpingchange 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 Prior Authorization Associate Level I is responsible for all aspects of the prior authorization process. The individual will beexpected to work cross-functionally across many departments (sales, operations, billing, and labteams) to serve our patient and client needs. This role will demonstrate knowledge by determining initial and/or ongoing eligibility, coverage in addition to assessing if a prior authorization is needed for reimbursement of a claim. This role will identify deficiencies within the Prior Auth process, assist with triaging, and document actions taken within the systems. This role will be responsible for the working accounts held within the dedicated work queues on a daily basis. This role will also support the broader activities of ensuring appropriate coverage by utilizing Epic, external portals, and other software, and communicate all applicable information to ancillary departments and other teams within the reimbursement operations departments. Essential Duties Include, but are not limited to, the following: Independently determine initial or ongoing patient insurance eligibility verification, investigate, and correct accounts within Epic; including updates to patient demographics, financial information, and guarantor information. Ability to interact with various insurances and third-party payors accurately and timely to ensure authorization is obtained and documented based on internal and external policies and regulations. Research missing or erroneous information on accounts using various portals and other resources; including outreach and identification of unknown payors. Review/edit claims and appeals prior to submitting to clearinghouse. Analyze, research, and resolve claim issues applying federal, state, and payor rules and procedures with a high degree of independence. Monitor WQ\'s for claims that need additional research and actions taken to get on to path of resolution. Responsible for CRM support. Has exceptional understanding of Claim Edit and Follow Up WQs. Utilize Onbase to work documents... For full info follow application link. 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. ***** APPLICATION INSTRUCTIONS: Apply Online: ipc.us/t/9830FB9361B242E6