The Role
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.
Summary Generated by Built In
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
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.
Skills Required
- High school diploma or GED
- Previous health insurance billing experience
- Working knowledge of medical terminology
- Strong problem-solving skills and ability to adapt to policy, regulation, and procedure changes
- Excellent written and verbal communication skills
- High attention to detail
- Ability to interact effectively with others
- Ability to maintain confidentiality
- Proficient computer skills with Microsoft Word and Excel
Quadax Compensation & Benefits Highlights
The following summarizes recurring compensation and benefits themes identified from responses generated by popular LLMs to common candidate questions about Quadax and has not been reviewed or approved by Quadax.
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Leave & Time Off Breadth — PTO, holidays, and short-errand flex time indicate a broad time-off offering. Access to time off is often seen as a meaningful offset to lighter cash compensation.
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Retirement Support — A 401(k) with company match is part of the package. This is highlighted as a valued component even when cash pay is viewed as moderate.
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Wellbeing & Lifestyle Benefits — Wellness initiatives, employee discounts, and community programs add lifestyle value. These perks contribute to a more rounded benefits experience.
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The Company
What We Do
Quadax is a healthcare revenue cycle technology and services company focused on making the business of healthcare run better. Quadax enables clients to collect more and enhance visibility into their business, allowing them to focus on their role in providing quality healthcare.
