Insurance Specialist
Quadax, Inc.•Middleburg Heights, OH
About The Position
This role involves managing insurance claims, including following up on claim status, resolving rejections, verifying patient insurance, and analyzing payer correspondence. The specialist will investigate electronic claim rejections, submit claims for corrections, and research payment retractions. Additionally, the role requires monitoring payer trends, meeting performance goals, and performing other assigned duties.
Requirements
- 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
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.
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What This Job Offers
Career Level
Mid Level
Education Level
High school or GED
