Remote After Training: Prior Authorization Specialist

Quadax, Inc.; Middleburg Heights (OH); Hybrid; USD 26,000 - 30,000; Full time

Job summary

Quadax, Inc. is hiring for a position focused on medical prior authorization and insurance billing. The role requires transitioning from onsite training in Middleburg Heights, Ohio to remote work after an initial 3-month period.

The ideal candidate has a high school diploma or GED, health insurance billing experience, familiarity with medical terminology, and strong attention to detail. Proficiency in Excel and Word, plus excellent communication, is required. Salary range: $19–$22 per hour.

Qualifications

• High School diploma or GED.
• Health insurance billing experience.
• Working knowledge of medical terminology.
• Proficient and attentive to details.
• Excellent written and verbal communication skills.
• High attention to detail.
• Ability to maintain confidentiality.
• Proficient in using Microsoft Excel and Word.
• Ability to multitask, establish priorities, and work independently.

Responsibilities

• Review case and insurance coverage information to customize the prior authorization request to the insurance company or physician’s office.
• Navigate through payer portals to initiate/obtain prior authorization status.
• Provide insurance company representatives with an overview of the services being submitted for prior authorization.
• Answer questions regarding the reimbursement process and direct testing specific and treatment questions.
• Complete LOMN (letter of medical necessity) form based on client or insurance requirements and fax to the ordering physician’s office for completion.
• Follow up with the insurance company or physician’s office as needed.
• Meet benefit investigation process standards by completing assigned worklist tasks in a timely manner and/or reporting to management when assistance is needed to complete the task.
• Participate in team meetings by sharing the details of cases worked.
• Comply with all applicable SOPs.
• Meet or exceed productivity and quality KPI goals.
• Perform other duties as assigned.

Skills

Communication skills

Multitasking

Attention to detail

Confidentiality

Independent work

Education

High School diploma or GED

Tools

Microsoft Excel

Microsoft Word

Job description

Quadax, Inc. is hiring for a position focused on medical prior authorization and insurance billing. The role requires transitioning from onsite training in Middleburg Heights, Ohio to remote work after an initial 3-month period.

The ideal candidate has a high school diploma or GED, health insurance billing experience, familiarity with medical terminology, and strong attention to detail. Proficiency in Excel and Word, plus excellent communication, is required. Salary range: $19–$22 per hour.