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ID 2020-1606
What you’ll be doing: - Articulate Quadax’s value to prospective clients through phone calls, emails, and social media - Partner with account executives to generate qualified pipeline that exceeds our sales goals. - Respond to inbound inquiries and develop interest into qualified sales opportunities. - Become an expert on lead generation tools to create accurate and targeted lists of prospects and call plans. - Act as a trusted advisor for prospects delivering industry knowledge and guidance - Contribute to the successful creation and execution of marketing campaigns that lead to new business. - Become an industry insider, providing insight and feedback of changes to healthcare and competitors back to Quadax. - Create a data driven, culture of success by maintaining an accurate and up-to-date CRM database (Salesforce.com) - Use your detective skills to gain understanding of assigned territories, strategic accounts, and most importantly what your prospects need. - Facilitate business conversations between account executives and prospective clients while managing calendars and accuracy of activity in CRM.
Job Locations
US-GA-Atlanta
Category
Sales
ID 2020-1591
- Plan, research, design and implementation of security architecture for new Quadax applications - Ensure the protection of data, infrastructure and applications for new Quadax applications - Collaborate, implement and maintain corporate security policies and procedures - Create proof-of-concepts and present ideas - Elicits requirements using interviews, document analysis, requirements workshops, surveys, site visits, business process descriptions, use cases, scenarios, business analysis, task and workflow analysis - Ensures the organization's data and infrastructure are protected by enabling the appropriate security controls - Estimate cost and budget for security updates - Maintain up to date with the latest security systems, standards, authentication protocols, and products - Collaboration with other technical teams during security or other IT updates - Perform penetration testing on new application architecture specifically related to new product service lines. - Anticipate security alerts, incidents and disasters and reduce their likelihood - Research, evaluate, and prototype new methodologies, technologies, and products - Responding quickly and effectively to all security incidents and providing post-event analyses
Job Locations
US-OH-Middleburg Heights
Category
Information Technology
ID 2020-1590
- Execute the processes that ensure accuracy and completeness of all insurance data stored in our database. - Perform QA and approval processes to add new or update existing insurance data and conduct regular reviews and maintenance to update or remove inaccurate data in the database. - Assist in building and maintaining a knowledge base of payer information. Examples:  - Data points necessary to transmit insurance information electronically. - Availability of EDI capability for eligibility, claim, remit, claim status and other transactions - Payer contact information - Claim and appeal processing times - Follow processes to resolve fall-out/exception cases from client or Quadax products utilizing QPIM. - Identify payer data trends through analysis of worklists and other curation tools, and communicate these to management to improve workflows on specific payers. - Maintain the QPIM Blues Prefix List - Help develop additional features such as links for a current library of all payer forms (e.g. consent, appeal)
Job Locations
US-OH-Middleburg Heights
Category
Information Technology
ID 2020-1580
- Analyze the business-IT environment (run, grow and transform the business) to detect critical deficiencies, and recommend solutions for improvement (systems of record, differentiation and innovation) - Assist with the delivery cloud based application architectures and development, integration, distributed data management, and application testing - Collaborate with business users, design, development and QA teams to help identify and develop creative solutions for complex technical requirements and processes. Adheres to overall reference architecture - Consistently demonstrates ability to apply proven and experiential methods to break down and address complex business and IT related issues - Consult with development teams and DevOps and acts as an advisor to other domain functions - Consult with and develop technical resources for methods, procedures, and standards to use during design, development, and unit testing phases of the project - Creates written documentation in the form of updated business processes, procedures, checklists, work aids, or training materials - Create proof-of-concepts and present ideas - Define the principles, guidelines, standards and solution patterns to ensure solution decisions are aligned with the enterprise's future-state architecture vision - Define, communicate, and understands the "big picture” in terms of the overall integration solution (both functional and technical components) and break it down into smaller manageable work units - Design and direct the governance activities associated with ensuring solutions architecture assurance and compliance - Develop a roadmap for the evolution of the enterprise application portfolio from future to current state (as defined by the solutions architecture) - Develop and design architectural blueprints and evolutionary roadmap that defines and communicates the strategic direction for IT architectures in support of business and technical strategies - Develop and enhance IT standards, principles, policies and guidelines and secure their endorsement by IT Management - Develop and maintain architectural blueprints and evolutionary roadmap that defines and communicates the strategic direction for IT architectures in support of business and technical strategies - Develop, support and continually improve the Enterprise Architecture (EA) practice - Drive digital innovation by leveraging innovative new technologies and approaches to renovate, extend, and transform the existing core technology base and IT estate - Introduces and accelerates new digital transformation technologies and methodologies to support technology transformation - Monitor the current-state solution portfolio to identify deficiencies through aging of the technologies used by the application, or misalignment with business requirements - Support technology direction, build consensus, and architectural decisions to deliver superior RCO solutions  
Job Locations
US-OH-Middleburg Heights
Category
Information Technology
ID 2020-1577
- Review and submit claims based on payer guidelines and within the filing time limits. - Obtain updated or missing claim information from physicians and/or patients. - Complete assigned claim and follow-up worklist tasks. - Provide insurance companies with the test descriptions, results, medical records, tax information, and licenses when requested. - Call insurance companies to determine the status of claims submitted. - Comply with all Billing and Follow-up Worklist process, system, and documentation SOPs. - Meet claim filing and follow-up deadlines by completing assigned worklist tasks in a timely manner and/or reporting to management when assistance is needed to complete the tasks. - Report all changes to insurance company claim processing requirements to the Billing Manager. - Participate in team meetings by sharing the details of cases worked. - Other duties as assigned.
Job Locations
US-OH-Milan
Category
Administrative/Clerical
ID 2020-1568
- Assist clients with setup, some implementation, and daily operations of the Quadax electronic claims processing software called Xpeditor. - Must be ready and able to train staff (current and new) on product features as well as everyday use. - Read multiple reports and try to identify billing trends for clients. - Present clients with additional products and features. - Contact different insurance payers while researching reasons why medical claims did not pay or pass edits. - Assist clients in writing custom data converts and test these upon implementation. - Other duties as assigned.
Job Locations
US-SD-Sioux Falls
Category
Customer Service/Support
ID 2020-1566
- Review case and insurance coverage information to customize the content of the call to the insurance company or physician’s office. - Provide insurance company representatives with an overview of the services in which coverage is being requested in the attempt to obtain prior authorization. - Answer questions regarding the reimbursement process and direct testing specific and treatment questions. - Complete SMN (statement of medical necessity) form based on client or insurance requirements and fax to the ordering physician’s office for completion. - Follow up contact may be needed with the insurance company or physician’s office based on pending documentation or approval. - 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. - Other duties as assigned.
Job Locations
US-OH-Milan
Category
Administrative/Clerical
ID 2020-1564
- Answer incoming telephone and email inquiries, providing an outstanding customer experience. - Review case history and insurance notes to provide appropriate information to callers. - Make outbound calls to Physicians, Patients, Parents/Spouse. - Call physicians to obtain information or provide information pertaining to a case or issue. - Communicate results of a benefit investigation to patient and physicians. - Pre-qualify patients for any available financial aid or clearly communicate out of pocket costs. - Respond to inquiries and complete worklist tasks in a timely manner. - Initiate appeals or patient billing process when needed. - Report all insurance company trend changes to the Call Center Supervisor or Manager. - Participate in team meetings by sharing the details of cases worked. - Other duties as assigned by Supervisor or Manager.
Job Locations
US-OH-Middleburg Heights
Category
Administrative/Clerical
ID 2020-1563
- Review and submit claims based on payer guidelines and within the filing time limits. - Obtain updated or missing claim information from physicians and/or patients. - Complete assigned claim and follow-up worklist tasks. - Provide insurance companies with the test descriptions, results, medical records, tax information, and licenses when requested. - Call insurance companies to determine the status of claims submitted. - Comply with all Billing and Follow-up Worklist process, system, and documentation SOPs. - Meet claim filing and follow-up deadlines by completing assigned worklist tasks in a timely manner and/or reporting to management when assistance is needed to complete the tasks. - Report all changes to insurance company claim processing requirements to the Billing Manager. - Participate in team meetings by sharing the details of cases worked. - Other duties as assigned.
Job Locations
US-OH-Milan
Category
Administrative/Clerical
ID 2020-1554
- Review and process overpayments. - Endorse and prepare client deposits. - Complete client bank reconciliations. - Credit card payment processing. - Complete monthly client billing. - Prepare checks (including refund checks) based upon authorized documentation. - Perform administrative duties. - Other duties as assigned.
Job Locations
US-OH-Middleburg Heights
Category
Administrative/Clerical
ID 2020-1553
- Assist clients with setup, some implementation, and daily operations of the Quadax electronic claims processing software called Xpeditor. - Must be ready and able to train staff (current and new) on product features as well as everyday use. - Read multiple reports and try to identify billing trends for clients. - Present clients with additional products and features. - Contact different insurance payers while researching reasons why medical claims did not pay or pass edits. - Assist clients in writing custom data converts and test these upon implementation. - Other duties as assigned.
Job Locations
US-Remote | US-GA-Macon | US-FL-Jacksonville | US-FL-Tampa
Category
Customer Service/Support
ID 2020-1550
- Review case and insurance coverage information to customize the contents of the call to the patient. - Call and follow up with the patient to explain their insurance benefits and any financial assistance programs. - Answer questions regarding the reimbursement process and direct testing specific and treatment questions as needed. - Send a fax and/or call the requesting physicians to notify them that the benefit investigation process has been completed. - Notify Customer Service when a patient does not want to move forward with the test ordering. - Comply with all Patient Notification and MD Notification worklist process and documentation SOPs. - Meet benefit investigation process standards by completing the worklist tasks in a timely manner and/or reporting to management when assistance is needed. - Participate in team meetings by sharing the details of the cases worked. - Other duties as assigned.
Job Locations
US-OH-Middleburg Heights
Category
Administrative/Clerical
ID 2020-1545
- Review case and insurance coverage information to customize the content of the call to the insurance company or physician’s office. - Provide insurance company representatives with an overview of the services in which coverage is being requested in the attempt to obtain prior authorization. - Answer questions regarding the reimbursement process and direct testing specific and treatment questions. - Complete SMN (statement of medical necessity) form based on client or insurance requirements and fax to the ordering physician’s office for completion. - Follow up contact may be needed with the insurance company or physician’s office based on pending documentation or approval. - 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. - Other duties as assigned.
Job Locations
US-OH-Middleburg Heights
Category
Administrative/Clerical
ID 2020-1534
- Review patient medical record and payer medical policies to determine validity of denials. - Execute phone calls to payers to challenge denials and request re-processing where denials are invalid. - Submission of and follow-up on payer reconsideration requests; providing additional challenges to payers. - Recognize and report payer trends to Management and Client. - Create detailed spreadsheets as requested by Management. - Complete payer projects as requested by Client or Management. - Research payer medical policies and insurance plan types to insure up-to-date information is on file. - Review assigned denials and EOBs for appeal filing information. Gather any missing information. - Review case history, payer history, and state requirements to determine verbal challenge and appeal strategy. - Gather and fill out all special appeal or review forms. - Create appeal letters, attach the materials referenced in the letter, and mail them. - Comply with Appeal or Insurance processes, system, and documentation SOPs. - Participate in team and appeal meetings by sharing the details of cases worked. - Act as a backup on additional production based work lists, as needed. - Ability to meet predetermined Productivity Goals - Ability to meet Quality Standard in place (90% or greater). - Other duties as assigned.
Job Locations
US-OH-Middleburg Heights
Category
Administrative/Clerical
ID 2020-1515
- Answer incoming telephone and email inquiries, providing an outstanding customer experience. - Review case history and insurance notes to provide appropriate information to callers. - Make outbound calls to Physicians, Patients, Parents/Spouse. - Call physicians to obtain information or provide information pertaining to a case or issue. - Communicate results of a benefit investigation to patient and physicians. - Pre-qualify patients for any available financial aid or clearly communicate out of pocket costs. - Respond to inquiries and complete worklist tasks in a timely manner. - Initiate appeals or patient billing process when needed. - Report all insurance company trend changes to the Call Center Supervisor or Manager. - Participate in team meetings by sharing the details of cases worked. - Other duties as assigned by Supervisor or Manager.
Job Locations
US-OH-Middleburg Heights
Category
Administrative/Clerical
ID 2020-1510
- Review case history to ensure all means to obtain reimbursement from the insurance company have been completed and verify it is appropriate to move forward with the patient billing process. - Notify the client via email alert that one of their patients is entering into the patient billing process. - Answer questions from the client regarding a patient’s case history. - Call patients for updated insurance information. - Call the patients to offer them financial assistance and payment plans. - Review/approve statement balance. - Send letters and billing statements to the patients. - Send financial assistance applications to patients and process returned financial assistance documents. - Send monthly invoices to the client bill/roster accounts. - Make follow-up calls to the client bill accounts when their payment is past due. - Comply with all Patient Billing and Client Billing process, system, and documentation SOPs. - Meet patient and client billing process time standards by completing assigned worklist tasks in a timely manner and/or reporting to management when assistance is needed to complete the tasks. - Participate in team meetings by sharing the details of cases worked. - Act as backup on answering incoming telephone calls as needed. - Other duties as assigned.
Job Locations
US-OH-Middleburg Heights
Category
Administrative/Clerical
ID 2020-1505
- Follow-up with and resolve outstanding accounts receivable balances. - Respond to payer correspondence. - Draft appeals for denied claims. - Research requests for insurance payment retractions. - Research overpayments and communicate to Treasury for resolution. - Investigate electronic claim rejections. - Research claim information through web portals. - Other duties as assigned.
Job Locations
US-OH-Middleburg Heights
Category
Customer Service/Support
ID 2020-1499
- Review case and insurance coverage information to customize the content of the call to the insurance company or physician’s office. - Provide insurance company representatives with an overview of the services in which coverage is being requested in the attempt to obtain prior authorization. - Answer questions regarding the reimbursement process and direct testing specific and treatment questions. - Complete SMN (statement of medical necessity) form based on client or insurance requirements and fax to the ordering physician’s office for completion. - Follow up contact may be needed with the insurance company or physician’s office based on pending documentation or approval. - 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. - Other duties as assigned.
Job Locations
US-OH-Middleburg Heights
Category
Administrative/Clerical
ID 2019-1481
- Design and develop new products using microservice architectures - Troubleshoot problems, diagnose and resolve product issues - Analyze requirements to assist in the creation, grooming, and estimating of user stories - Recommend design patterns and coding standards - Build and enhance new services and applications using C#, .NET Core, and JavaScript - Participate in code reviews to ensure code quality - Collaborate with others to ensure best practices are followed - Mentor junior developers
Job Locations
US-OH-Middleburg Heights
Category
Information Technology
ID 2019-1474
- Provide technical expertise in the design and development cycles - Evaluate new and emerging technologies - Analyze requirements to assist in creating, grooming, and estimating of user stories - Define and enforce software architecture standards, the use of design patterns, and coding standards - Build and enhance new services and applications using C#, .NET Core, and JavaScript - Participate in code reviews to ensure code quality - Collaborate with software architects, enterprise architects, DevOps, and others - Mentor team members to fill knowledge gaps and facilitate their growth  
Job Locations
US-OH-Middleburg Heights
Category
Information Technology