Insurance Specialist

Quadax; Middleburg Heights (OH); On-site; USD 42,000 - 60,000; Full time

Job summary

Quadax in Middleburg Heights, OH is seeking a detail-oriented Medical Billing Specialist to manage claim statuses, follow up with payers, and resolve rejections. You will verify patient insurance eligibility and coordinate benefits while reviewing payer correspondence to ensure accurate processing.

You will monitor payer trends, support updates to policies, and strive to meet productivity and quality KPI goals, all while maintaining strict confidentiality and compliance with industry regulations.

Qualifications

• High School diploma or GED required.
• 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 and confidentiality.

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.

Skills

Problem-solving

Communication

Attention to detail

Interpersonal skills

Confidentiality

MS Word & Excel

Education

High School diploma or GED

Tools

Microsoft Word

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
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