Insurance Specialist

Quadax, Inc.; Middleburg Heights (OH); On-site; USD 36,000 - 48,000; Full time

Job summary

Quadax, Inc. is seeking a Health Insurance Billing Specialist in Middleburg Heights, Ohio to manage claim status, verify eligibility, and resolve rejections. You will interact with payers and patients, ensuring accurate processing and timely communications.

The role emphasizes attention to detail, problem-solving, and adherence to confidentiality while maintaining strong written and verbal communication with stakeholders.

Qualifications

• High School diploma or GED required.
• Previous health insurance billing experience preferred.
• Working knowledge of medical terminology.
• Strong problem-solving skills and adaptability to policy changes.
• Excellent written and verbal communication skills.
• High attention to detail and confidentiality.
• Proficient with Microsoft Word and Excel.

Responsibilities

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

Skills

Attention to detail

Problem-solving

Communication skills

Adaptability

Team collaboration

Education

High School diploma or GED

Medical terminology knowledge

Previous health insurance billing experience

Tools

Microsoft Word

Microsoft Excel

Job description

• 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

Equal Opportunity Employer
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.