Job Description:
• Assist with planning, fieldwork, and documentation of audits and reviews of laboratory revenue cycle operations to assess compliance with regulatory requirements.
• Analyze billing data and trends to detect and prevent fraud, waste, abuse, and potential coding issues through the use of data analytics.
• Conduct and document audits and reviews of third party vendors, international distributors, and interactions with HCPs/HCIs and other high-risk interactions to assess compliance with regulatory requirements and company policy.
• Work with other compliance and legal staff to investigate and resolve reported compliance concerns related to revenue cycle functions.
• Maintain awareness of the federal, state, and local regulatory environment related to the reimbursement of laboratory services to monitor relevance to the Exact Sciences’ Compliance Program.
• Identify potential weaknesses in revenue cycle functions and activities and proactively suggest improvements to address them.
• Lead walkthroughs, document narratives, and test assigned processes and controls for Exact Sciences’ laboratory entities to ensure compliance with all policies, procedures, and processes.
• Prepare internal audit reports, participate in close meetings, and present summaries internally.
• Make process improvement suggestions to company management based on audit results.
• Follow up on outstanding compliance issues from previous audits.
• Liaise with external auditors including, but not limited to, documentation, testing, coordination, and follow ups related to findings, as needed.
• Utilize interdepartmental collaboration skills to engage across teams.
• Ability to analyze processes and determine if adequate controls are in place and appropriate for the related activity.
• Ability to take direction and independently work towards achievement of projects.
• Ability to articulate complex information into understandable terms and effectively communicate at all levels within an organization.
• 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 designated schedule.
• 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.
• Ability to travel 25% of working time away from work location, may include overnight/weekend travel.
Requirements:
• Bachelor’s degree in Accounting, Finance, Healthcare Administration, or a related field as outlined in the essential duties.
• 3+ years of experience in a role requiring adherence to process, internal controls, or internal/external audit experience.
• Demonstrated ability to execute auditing activities.
• Strong written and oral communication skills.
• Knowledge of the health care industry, including experience in auditing compliance with the requirements of AdvaMed, FCPA, AKS, FCA, etc.
• Knowledge of Federal, State and local health care laws and regulations, as well as applicable regulatory agencies.
• Ability to work both independently and collaboratively with cross-functional teams.
• Strong analytical skills with the ability to interpret complex data sets and regulations.
• Advanced skills in Microsoft Office (Specifically Word, PowerPoint, Excel).
• Demonstrated ability to perform the essential duties of the position with or without accommodation.
• Authorization to work in the United States without sponsorship.
Benefits:
• paid time off (including days for 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