The Patient Financial Services Associate II (PFSAII) position is responsible for the accurate and timely processing of claims, appeals, denials, and statements for Exact Sciences. A PFSAII demonstrates medical insurance knowledge by resolving billing discrepancies, eligibility, denials, appeals, and aged unpaid claim follow up for commercial, government, and plan coverage for optimal Account Receivable (AR) outcomes. Independently determine initial or ongoing patient insurance eligibility verification, investigate, and correct accounts within Epic. Interact with various insurances and third-party payors to ensure authorization is obtained and documented. Research missing or erroneous information on accounts using various portals and resources. Review/edit claims and appeals prior to submitting to clearinghouse. Analyze, research, and resolve claim issues applying federal, state, and payor rules and procedures. Correct rejected claims from the claim’s scrubber, clearinghouse, or payor. Review explanations of payments and complete appropriate steps for all denials. Investigate payor underpayments and follow up with payors on unpaid aging claims. Provide supporting documentation needed by insurance payor. Perform accurate and timely write-offs for uncollectible accounts. Participate in team meetings sharing denial trends and contributing ideas for workflows and best practices. Provide ad-hoc support within the department as necessary. Complete position responsibilities within the appropriate time frame while adhering to quality standards. Stay current with relevant medical billing regulations, rules, and guidelines. Maintain strictest confidentiality; adhere to all HIPAA guidelines/regulations. Demonstrate excellent problem-solving abilities and organizational skills. Communicate effectively with all levels of staff through verbal and written communications. Work in a team environment and adapt to changing workload and circumstances effectively. Demonstrate reliability and professionalism in all interactions. 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. Work normal schedule of Monday through Friday during normal business hours. Work in front of a computer screen and/or perform typing for approximately 90% of a typical working day. Use a telephone through a headset.