Remote Triage Order Quality Specialist II

Thornton Tomasetti; United States; Remote; USD 36,000 - 70,000; Full time

Job summary

Abbott is seeking a TOQII to handle accurate and timely filing of insurance claims for Cancer Diagnostics. The role requires Epic, OnBase, and payer communication to ensure approvals and accurate reimbursements.

Remote-based in the United States, you will verify patient insurance eligibility, resolve claim issues, and support reimbursement operations while maintaining HIPAA compliance and high-quality standards.

Qualifications

• High School Diploma or GED completed.
• 1+ years of TOQ Associate Level I experience.
• 3+ years in medical billing, claims, or insurance processing.
• Knowledge of government, managed care and commercial claim rules.
• Knowledge of medical terminology and health insurance terms.
• Familiarity with EHR systems and electronic records.
• Proficiency with computer systems and keyboarding.
• Authorization to work in the United States without sponsorship.

Responsibilities

• Verify initial or ongoing patient insurance eligibility and update Epic records.
• Interact with insurers to obtain authorizations and document policies.
• Review and edit claims before submission to the clearinghouse.
• Research denials and resolve claim issues per payor rules.
• Monitor work queues and action items to progress to resolution.
• Provide CRM support and OnBase document processing.
• Assist with ad hoc projects and outages as needed.

Skills

Attention to detail

Communication skills

Teamwork

Independent work

HIPAA compliance

Education

GED/High School Diploma

Associate degree in medical billing

Tools

Epic

OnBase

CRM system

Payor portals

Job description

Abbott is seeking a TOQII to handle accurate and timely filing of insurance claims for Cancer Diagnostics. The role requires Epic, OnBase, and payer communication to ensure approvals and accurate reimbursements.

Remote-based in the United States, you will verify patient insurance eligibility, resolve claim issues, and support reimbursement operations while maintaining HIPAA compliance and high-quality standards.