Senior Billing Compliance Auditor

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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 Senior Billing Compliance Auditor will play a critical role in ensuring the accuracy, integrity, and compliance of the organization’s billing practices. This individual will execute audit projects, assess risks associated with billing, regulatory, and operational risk, and work closely with internal teams to implement corrective actions and improve processes. The Senior Billing Compliance Auditor will also help identify regulatory risks, provide actionable insights, and support the development of a strong internal control environment. This role requires a deep understanding of internal audit standards, compliance requirements, and is familiar with healthcare billing as well as strong analytical and problem-solving skills.

This position is remote.

Essential Duties

Include, but are not limited to, the following:

• 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.
• 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.
• Conduct documentation walkthroughs and testing of 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 and means to travel 15% between local Exact Sciences locations.
• Ability to travel 15% of working time away from work location, may include overnight/weekend travel.

Minimum Qualifications

• Bachelor’s degree in Accounting, Finance, Healthcare Administration, or a related field as outlined in the essential duties.
• 2+ years of Big 4 accounting firm experience or 4+ years of experience in a role requiring adherence to process, internal controls, and internal/external audit experience. Demonstrated ability to execute auditing activities.
• Strong written and oral communication skills.
• Ability to work both independently and collaboratively with cross-functional teams.
• Strong analytical skills with the ability to interpret complex data sets and regulations.
• Proficient 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.

Preferred Qualifications

• Public accounting experience.
• Advanced knowledge with data analytics platforms (Tableau or PowerBI)
• Familiarity with the regulatory framework governing healthcare billing, including the Centers for Medicare and Medicaid Services (CMS), Office of Inspector General (OIG), and payer-specific guidelines.
• Certified Public Accountant (CPA) or Certified Internal Auditor (CIA) designation.

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.

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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.