Jobs at Quadax

Follows up with payers and patients on claim adjudication, resolves rejections, verifies eligibility and coordination of benefits, submits corrected or secondary claims, reviews payer correspondence, researches payment retractions, and monitors claim-processing trends. Maintains productivity and quality goals while handling confidential information and adapting to changing insurance policies and procedures.

Supervise billing department staff, coordinate assignments and staffing, monitor turnaround times, productivity, quality, and overtime, and conduct performance reviews. Resolve complex billing issues with insurance companies, support client meetings, communicate policy and SOP updates, coach employees, and recommend process improvements. Represent the department when the manager is absent and assist with planning resources to achieve departmental goals.

Processes insurance denials and submits timely appeals, external review requests, documentation, and appeal letters. Reviews EOBs, payer histories, case requirements, and state rules to develop appeal strategies. Coordinates consent, medical records, forms, phone hearings, and communications with patients, physicians, insurers, and state agencies. Maintains productivity and quality standards, meets filing deadlines, reports denial trends, answers calls as needed, and supports special projects.

Analyze healthcare revenue cycle data to generate actionable insights, improve product design and user experience, and support data quality. Responsibilities include data preparation, transformation, validation, visualization, statistical analysis, AI/ML solution development, document intelligence using OCR and LLMs, and deploying machine learning models with Azure services.

Supervise accounts receivable and receipts teams supporting client month-end close, payment reconciliation, audits, quality metrics, staffing, training, and performance management. Develop procedures, trackers, action plans, and process improvements; coordinate global and domestic teams; communicate client process changes; oversee department projects; and ensure productivity, accuracy, continuity, and compliance with company procedures.

Analyzes healthcare revenue cycle and accounts receivable data to identify payer reimbursement trends and revenue opportunities. Performs root cause analysis, recommends corrective actions, tracks reimbursement improvements, evaluates client KPIs, and prepares reports and presentations for clients, account executives, and management. Uses Excel, Power BI, SQL, and other tools to create analyses and collaborates with Business Intelligence on reporting enhancements.

Develop and maintain Power BI dashboards, reports, scorecards, data models, and analytical solutions for healthcare revenue cycle operations. Gather requirements, write and optimize SQL, validate data, resolve discrepancies, and deliver actionable financial and operational insights. Collaborate with leadership, technical teams, internal stakeholders, and clients while managing reporting projects, UAT, enhancements, automation, benchmarking, reimbursement analysis, and trend analysis.

Provides second-level technical support for EDI remittance processing. Researches and resolves transmission issues, monitors payer remits, maintains remittance configurations and mappings, supports testing of enhancements and bug fixes, configures client reports, and analyzes ANSI 835 data and enhancement requests. Collaborates with payers, clients, call center personnel, and internal teams while maintaining confidentiality and prioritizing work in a fast-paced environment.

Test and validate Power BI reports and dashboards, verify data quality and ETL processes between sources and Snowflake, create and execute test plans/cases, document defects, validate security/role access, and collaborate with BI developers, data engineers, and analysts in an Agile environment.

The Client Integration Specialist manages client data integrations, oversees testing and documentation, communicates with clients, and coordinates projects to enhance software interfaces.

Manage RemitMax implementations and ongoing remittance management clients, coordinate with customers and partners, deliver training, support integration/configuration/testing, monitor adoption and performance, maintain project documentation, and perform QA for releases.

Serve as primary marketing contact for Laboratory Billing & Revenue Cycle Services. Coordinate annual marketing calendar, execute integrated campaigns, create content (blogs, case studies, newsletters, webinars), support sales with collateral and proposals, and manage event planning and post-event engagement to drive lead generation and customer engagement.