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Insurance Specialist

Role overview

Summary

The Insurance Specialist role focuses on managing and resolving insurance claims and eligibility issues. You will work with payers and patients to ensure accurate processing and communication of claims, contributing to the efficiency of the billing process.

Qualifications

  • High School diploma or GED.
  • Previous health insurance billing experience.
  • Working knowledge of medical terminology.
  • Strong problem-solving skills and ability to adapt to changes.
  • Excellent written and verbal communication skills.

Responsibilities

  • Follow up on claim status via insurance portals or calls to payers.
  • Call payers and patients to resolve claim rejections and verify insurance coverage.
  • Verify patient insurance eligibility and coordination of benefits.
  • Review and analyze payer correspondence.

Key facts

Hard skills

Other skills

  • Problem Solving
  • Communication
  • Detail Oriented
  • Client Confidentiality
  • Adaptability

About the company

Quadax, Inc. logo

Quadax, Inc.

  • Digital Health
  • SME
  • 501–1,000
Quadax is the leading and trusted healthcare partner delivering revenue cycle optimization solutions driven by the needs of our clients, powered by business analytics, and supported by superior service to improve reimbursement of care.

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Job description

Remote: Although this position is listed as remote, the training period requires you working onsite 5 days/week for 3 months at our Middleburg Heights, Ohio facility before transitioning to remote. Due to business requirements, only applicants residing in Ohio will be considered.

 

Key Responsibilities:

  • Follow up on claim status via insurance portals or calls to payers to determine adjudication and details.
  • Call payers and patients as needed to resolve claim rejections, challenge processing decisions, and verify insurance coverage.
  • Verify patient insurance eligibility and coordination of benefits.
  • Review and analyze payer correspondence.
  • Investigate electronic claim rejections.
  • Submit claims for processing corrections, to secondary insurances, or to updated addresses.
  • Research requests for insurance payment retractions.
  • Monitor and notify management of payer trends and/or claim processing issues.
  • Meet or exceed productivity and quality KPI goals.
  • Perform other duties as assigned.

Education/Experience:

  • High School diploma or GED
  • Previous health insurance billing experience
  • Working knowledge of medical terminology
  • Strong problem-solving skills and the ability to adapt to changes in policies, regulations, and procedures
  • Excellent written and verbal communication skills
  • High attention to detail
  • Ability to interact effectively with others
  • Ability to maintain confidentiality
  • Proficient computer skills with knowledge of Microsoft Word and Excel

Salary Range: $19-$22 per hour

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