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ID 2023-2577
- Review assigned denials and EOB’s for appeal filing information. Gather any missing information. - Review case history, payer history, and state requirements to determine appeal strategy. - Obtain patient and/or physician consent and medical records when required by the insurance plan or state. - Gather and fill out all special appeal or review forms. - Create appeal letters, attach the materials referenced in the letter, and mail them. - Coordinate phone hearings with the insurance company, patient, and physician. - Comply with all 1st, 2nd, 3rd, and External Level Appeal process, system, and documentation SOP’s. - Meet appeal filing deadlines by completing assigned worklist tasks in a timely matter and/or reporting to management when assistance is needed to complete the tasks. - Report all insurance company or state requirements and denial trend changes to the Team Leader and Reimbursement Manager. - Participate in team and appeal meetings by sharing the details of cases worked. - Act as a backup on answering incoming telephone calls as needed. - May undertake special projects assigned by the Team Leader or Reimbursement Manager. - Ability to meet predetermined Productivity Goals based on the level of Appeal. - Ability to meet Quality Standard in place (90% or greater). - Other duties as assigned.
Job Locations
US
Category
Administrative/Clerical
ID 2023-2576
- 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
Category
Administrative/Clerical
ID 2023-2571
Key Responsibilities: - Follow-up with and resolve outstanding accounts receivable balances. - Call payers and patients as needed to resolve claim rejections. - Respond to payer correspondence. - Draft appeals for denied claims. - Research requests for insurance payment retractions. - Research overpayments and communicate to Treasury for resolution. - Monitor and notify management of payer trends and/or claim processing issues. - Investigate electronic claim rejections. - Research claim information through web portals. - Other duties as assigned.
Job Locations
US
Category
Administrative/Clerical
ID 2023-2569
PROJECT MANAGEMENT · Manage multiple team projects · Knowledge of PMBOK® methodology preferred · Develops communication plan · Document project scope, project tasks, timelines, and milestones · Documents resource assignments to tasks · Track progress and determines relative progress against plan · Proactively analyzes progress to date across all facets of the project plan · Communicates regularly and effectively with project team, sponsors, stakeholders, and clients · Documents project risk and mitigation plans · Documents issues and action items · Lead and documents project meetings · Awareness of change management techniques to help support project success · Assume other duties, as assigned by manager   LEADERSHIP · Ability to provide input on the development/maintenance of project tool kit, according to best practices · Ability to drive a project with a project plan and supervision support · Oversight of project team activities throughout the project life cycle   INDUSTRY · Experience managing projects · Knowledge of healthcare billing preferred · Experience working in finance, healthcare, or insurance-related environments preferred
Job Locations
US-OH-Middleburg Heights
Category
Management
ID 2023-2568
- Apply your technical expertise to design and develop new products - Mentor team members to facilitate their growth - Define and enforce software design standards and coding best practices - Actively participate in code reviews to ensure code quality - Collaborate with technical and product teams to refine requirements  
Job Locations
US
Category
Information Technology
ID 2023-2567
- Communicate directly with a diverse client base as well as internal employees in order to provide support of various applications, operations, and processes. - Gather, analyze, and interpret detailed information for requests/issues from end-users to be utilized for resolution or to be documented for proper escalation. - Use of internal Help Desk trouble ticketing application to log, track, and escalate user issues including: - Portal registration approval, deactivation, and troubleshooting - Operator code setup, grant additional access, reset passwords - Intake client/employee inquiries of various kinds and determine proper routing for resolution - Monitoring of interface files - Troubleshoot and report system performance issues - Applications break/fix triage and resolution communication - Unplanned outage and schedule downtime notifications - Other duties as assigned.
Job Locations
US-OH-Middleburg Heights
Category
Customer Service/Support
ID 2023-2566
- Support the marketing strategy and campaign management to drive growth and business impact in revenue cycle services. - Identify tactics, channels, and strategies to connect with revenue cycle decision makers in hospitals, physician groups, labs, billing services, clinics, and other health care organizations. - In collaboration with product, sales, and marketing, lead the development of campaign content and messaging by translating technical details into benefits for buying personas.   - Execute research and discovery against our target audience and industry, uncovering new areas of opportunities, audience insights and competitive analysis to elevate product marketing. - Coordinate and support the development of pre- and post-event communications, supporting assets and collateral, onsite marketing initiatives and demand generation. - Support the content development and execution of account-based marketing (ABM) program for key accounts. - Articulate and leverage the organization’s unique abilities to deliver value to the market. - Learn the competition, assess strengths and weakness to develop strategies and content to elevate the brand, products, and services. - Collaborate with the team on what channels best align with our markets’ buying preferences. - Help identify and work with customers who are willing to give testimonials, case studies, be a reference and participate in events for content development and marketing. - Develop relevant content to be used for all go-to-market channels and materials such as press releases, blogs, white papers, social media, newsletters, email marketing, etc. - Create tools & content for salespeople focused on competitive analysis and the selling process.  - Provide needed market and solution information to support internal and external marketing and sales programs, marketing events and channel opportunities.
Job Locations
US-OH-Middleburg Heights
Category
Marketing
ID 2023-2560
  - Review and assist the work queues of Account Reps known to be out of the office while onsite at clients. - Serve as an overall lifeline for the entire Client Experience team.  Because of this, punctuality is a must.  It is important to be on time for work (8:00 am – 5:00 pm EST), meetings, and following through on a commitment.  - Contact & approve or reject new Quadax Portal login requests appropriately and timely.  - Provide backup support to cover phones for the Client Support Center (CSC) as needed. - Conduct new Xpeditor Hosted remote installs (including any additional add-on products purchased at the time of the new Xpeditor sale).   - Document and summarize all training activity within an Account Management Activity Report (AMAR), and then submit the report through SharePoint within 24-48 business hours after the remote/phone install has been completed. - Create & submit a weekly reporting. - Assist in researching and creating training material for the EDI Client Experience team (as assigned) and provide a training session based upon their findings. - Contribute to the maintenance and upkeep of the EDI Document Library by reviewing reference material and suggestions for updates, applying updates as approved, and then posting these documents within the Library.  - Attend not only their own weekly team meetings, but also their assigned teams’ meeting, general Client Experience EDI meetings. - Serve as a mentor to newly hired Client Experience employees and/or CSC Reps as called upon (which is often a fun and very rewarding experience). - Other duties as assigned.
Job Locations
US-OH-Middleburg Heights
Category
Customer Service/Support
ID 2023-2559
The MIT will gain knowledge and experience required for promotion to management positions under direction of experienced personnel by performing various assignments throughout a rotation of a variety of divisions within the organization.   - Receive classroom instruction in subjects related to their rotational experience. - Attend lectures, watch guest speakers, and create projects, oral presentations, and complete learning checks. - Assist with established accounts to gain familiarity. - Adhere to guidelines of a formal written training program. - Attend periodic evaluations. - Partner with managers to plan and direct the work of the organization. - Contribute to establishing policies and procedures under the supervision of an assigned mentor. - Achieve a passing score in all areas of the management training program in order to continue in the program. - Receives training and performs duties in several departments such as Finance, Client Services, Sales, Operations, Healthcare Data Solutions and IT. - Learn line and staff functions, operations, management viewpoints, and company policies and practices that affect each phase of the business. - Sets performance goals and objectives with upper management. - Monitors performance progress with management and key trainers. - Observes experienced workers to acquire knowledge of methods, procedures, and standards required for performance of departmental duties. - Receives training in functions and operations of related departments to facilitate subsequent transferability between departments and to provide greater promotional opportunities. - Other duties as assigned.  
Job Locations
US-OH-Middleburg Heights
Category
Human Resources
ID 2023-2557
- Ensure all newly presenting customer agreements are appropriately recorded within the customer invoicing system, relative to rates, units and effective dates. - Ensure month-end customer invoicing is completed and closed according to the pre-established month-end closing dates, distributing month-end reporting packages to the applicable stakeholders. - Establish standardized month-end reporting package that includes an analysis of billed services categorized by services and clients, while further conducting quarterly needs assessments for continued reporting enhancements. - Perform annual customer invoicing process improvement analysis, executing approved process improvement initiatives thereafter. - Maintain and enforce operational customer invoicing controls that ensures all services are billed accurately and in accordance with the prevailing customer agreement, while further conducting retrospective random audits of invoices. - Provide leadership to applicable resource(s) for the effective handling of team responsibilities, while further ensuring critical tasks have primary and secondary representation. - Participate in continued systems & procedural improvement initiatives that may intersect and benefit revenue integrity’s interests. - Monitor and serve on committees and teams as department representative. - Other duties as assigned.
Job Locations
US-OH-Middleburg Heights
Category
Accounting/Finance
ID 2023-2556
- Provide code review & best practice guidance to BI Developers - Supervise and mentor BI Developers - Optimize our Scrum & Kanban development process to ensure we maximize deliverables - Design, develop and maintain dashboards using the Sisense BI platform - Develop optimized data models for dashboards and analytic purposes - Query and analyze data stored in flat files, SQL Server and Snowflake - Perform data analysis, mapping and validation across various data sources to produce consolidated BI solutions - Create custom data extracts to support ad-hoc reporting requests - Design, develop and maintain ETL processes from various data sources into our Snowflake Enterprise Data Warehouse - Coordinate deployments and resolutions with vendor partners - Work alongside the Product Owner and Scrum Master to get products to market fast - Ensure superior Client experience and KPIs - Other duties as assigned.
Job Locations
US-OH-Middleburg Heights
Category
Information Technology
ID 2023-2554
- Leading efforts to counter security breaches and anticipating and reducing the likelihood of future security alerts, incidents, and disasters. - Defining, planning, implementing, maintaining, and upgrading security measures, policies, and controls. - Writing reports and providing insights on the efficacy of the current security policies, incident responses, disaster recovery plans, and other security-related information. - Assisting with the creation of updates and training programs to secure the network and train the employees. - Keeping the security systems up to date. - Monitoring security access and maintaining the relevant data. - Conducting vulnerability testing and risk analysis to assess security and performing internal and external security audits. - Validating penetration testing results from third-party firms and guiding remediation.  - Analyzing security breaches to identify the cause and to update incidence responses and disaster recovery plans. - Verifying and coordinating security plans with outside vendors. - Creating procedures for IT employees and training them in security awareness. - Working with Application Development teams to ensure secure applications.
Job Locations
US-OH-Middleburg Heights
Category
Information Technology
ID 2022-2551
- Manage and administer provider enrollment for electronic claims, remittance and eligibility on behalf of customers, collaborating directly with customers on payer enrollment execution & progress. - Collaborate directly with Company’s EDI division on the administration of all payer EDI transaction changes, ensuring applicable changes are appropriate communicated and orchastrated. - Proactively assess healthcare billing regulations, insurance company initiatives, and applicable compliance items through payer and industry publications, facilitating informative communication to Client Services, Production Operations and customers. - Actively participate in the Company’s monthly Insurance Committee meeting and other internal EDI meetings, ensuring that the RCS division’s interests are appropriately represented, while further ensuring applicable meeting detail is communicated across the division. - Audit forthcoming internal EDI claim edits for impact on RCS customers. - Validate daily claim and remittance processing for expected completeness, raising awareness and corrective action as applicable. - Resolve claim, remittance, eligibility and claim status transactional support events for internal and external customers by means of leveraging internal and payer resources, while further orchestrating communication and corrective activities. - Provide continuous management of new and evolving payer detail to ensure successful claim and remittance handling. - Conduct thorough review of new client implementations, ensuring setup is accurate with respect to insurance plans, claims, remittances, eligibility, claim status and various other revenue cycle management configurations. - Provide subject matter expertise to Client Services and Production Operations on claim, remittance, eligibility and claim status transaction edits and processing, acting as a liaison with the Company’s EDI division. - Other responsibilities as assigned.
Job Locations
US-OH-Middleburg Heights
Category
Customer Service/Support
ID 2022-2550
- 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-MI-Lansing
Category
Customer Service/Support
ID 2022-2540
- The EDI Internal Support Account Representative has an array of responsibilities and, therefore, should be comfortable with a fast-paced work day that often includes:  multi-tasking, prioritizing, training, remaining organized, problem solving with attention to detail, and the ability to keep calm with a positive attitude while working independently, with clients, and/or as a team.    - This individual not only reviews and assists the work queues of Account Reps known to be out of the office while onsite at clients, but they also serve as an overall lifeline for the entire Client Experience team.  Because of this, punctuality is a must.  It is important to be on time for work (8:00 am – 5:00 pm EST), meetings, and following through on a commitment.    - In between normal daily tasks, the Account Representative contacts & approves or rejects new Quadax Portal login requests appropriately and timely.  They will also cover phones for the Client Support Center (CSC) as needed.    - The Internal Support Account Representative will periodically conduct new Xpeditor Hosted remote installs (including any additional add-on products purchased at the time of the new Xpeditor sale).  Within 24-48 business hours after the remote/phone install has been completed, the Rep would document and summarize all training activity within an Account Management Activity Report (AMAR), and then submit the report through SharePoint.    - Like most departments within EDI, the Internal Support Account Representative is also responsible for creating & submitting a weekly report.  Additionally, Internal Support assists in researching and creating training material for the EDI Client Experience team (as assigned).  They might even be called upon to provide a training session based upon their findings.  Another project that the Internal Support Account Representative assists with is helping to maintain and organize SharePoint’s EDI Document Library. This requires an ongoing review of reference material, the proposal of new ideas for updates, applying updates as approved, and then posting these documents within the Library.     - Internal Support Account Representatives attend not only their own weekly team meetings, but also their assigned teams’ meeting, general Client Experience EDI meetings, etc.  Quality listening, quality communicating (hand-written, as well as verbally through phone conversations and in person), and following directions toward common Quadax goals with a positive, professional attitude are a must.  Idea generating, creativity, and public speaking are all helpful ingredients that aid in the success of an Internal Support Account Representative.  As comfort levels and experience continue to grow, one may eventually serve as a mentor to newly hired Client Experience employees and/or CSC Reps as called upon (which is often a fun and very rewarding experience).
Job Locations
US-OH-Middleburg Heights
Category
Customer Service/Support
ID 2022-2534
- Review assigned denials and EOB’s for appeal filing information. Gather any missing information. - Review case history, payer history, and state requirements to determine appeal strategy. - Obtain patient and/or physician consent and medical records when required by the insurance plan or state. - Gather and fill out all special appeal or review forms. - Create appeal letters, attach the materials referenced in the letter, and mail them. - Coordinate phone hearings with the insurance company, patient, and physician. - Comply with all 1st, 2nd, 3rd, and External Level Appeal process, system, and documentation SOP’s. - Meet appeal filing deadlines by completing assigned worklist tasks in a timely matter and/or reporting to management when assistance is needed to complete the tasks. - Report all insurance company or state requirements and denial trend changes to the Team Leader and Reimbursement Manager. - Participate in team and appeal meetings by sharing the details of cases worked. - Act as a backup on answering incoming telephone calls as needed. - May undertake special projects assigned by the Team Leader or Reimbursement Manager. - Ability to meet predetermined Productivity Goals based on the level of Appeal. - Ability to meet Quality Standard in place (90% or greater). - Other duties as assigned.
Job Locations
US
Category
Administrative/Clerical
ID 2022-2524
  - Assist clients with managing the medical billing and application customization aspects of a new implementation. - Work with the managers and billers of a hospital billing department to identify differences with how the Quadax proprietary medical claims processing software (i.e. Xpeditor) edits claims versus the hospital’s current EDI system. - Customize software and training individuals in large group settings. - Responsible for secondary billing and remittance overview. - Assist Account Representatives in handling issues that impact their clients. - Assist in research and problem solving and suggest a course of action. - Other duties as assigned.
Job Locations
US-OH-Middleburg Heights
Category
Customer Service/Support
ID 2022-2519
- Work with Benefits team to administer benefits programs including medical, dental, life, disability, 401k, and more - Administration of compensation and performance appraisals - Develop, coordinate, plan, facilitate, and promote health activities and programs for employees - Keep records and prepare reports on participation and effectiveness of programs - Administer 401k plan enrollment and submit benefit elections during new hire orientation & annual enrollment - Manage Worker’s Compensation claims; coordinate with employee and TPA to bring claims to resolution. - Coordinate leave of absence utilizing a thorough knowledge and experience with FMLA and ADA/ADAAA - Communicate with employees regarding case status for short term disability and FMLA - Process HR reporting on weekly and monthly basis - Assist in benefit audits - Maintain personnel files per legal requirements - Assist employees with benefit claim issues - Respond to benefits inquiries from employees - Back-up for FMLA process - Act as a liaison between HR and Accounting - Back-up to front desk Receptionist - Projects as assigned by HR Vice President
Job Locations
US-OH-Middleburg Heights
Category
Human Resources
ID 2022-2515
- Work closely with management to develop human resource practices that support and enable a client-focused, high-performing culture emphasizing teamwork, honesty, openness, respect, quality, productivity and results. - Administer, evaluate, and continuously improve HR programs such as benefits administration, performance management, and employee engagement. - Administer all employee benefit programs including medical, dental, vision. - Develop and continually enhance the company’s performance management process and procedures through effective administration of employee reviews, coaching managers on delivering feedback, and counseling     - Manage activities related to human resource programs including, but not limited to, compensation, benefits, and leave; disciplinary matters; disputes and investigations; performance and talent management; productivity, recognition, occupational health and safety; and training and development. - Maintains knowledge of HR trends, best practices, regulatory changes, and new technologies in human resources, talent management, and employment law. - Assist with SOC 2 certification audit. - Act as bridge between HR and our HRIS system: - Manage permissions access, personalization and settings for HRIS users. - Ensure compliance with data security and privacy requirements. - Confirm the accuracy and maintain the integrity of data entered in HRIS. - Perform data updates, exports, imports, clean-ups. - Respond to inquiries for reports from various members of management. - Process critical reporting such as our annual EEO-1, OSHA, 10-95 and ACA reports as well as regular overtime tracking, turnover, merit increase, etc. reporting. - Other responsibilities as assigned.
Category
Human Resources
ID 2022-2441
- Review assigned denials and EOB’s for appeal filing information. Gather any missing information. - Review case history, payer history, and state requirements to determine appeal strategy. - Obtain patient and/or physician consent and medical records when required by the insurance plan or state. - Gather and fill out all special appeal or review forms. - Create appeal letters, attach the materials referenced in the letter, and mail them. - Coordinate phone hearings with the insurance company, patient, and physician. - Comply with all 1st, 2nd, 3rd, and External Level Appeal process, system, and documentation SOP’s. - Meet appeal filing deadlines by completing assigned worklist tasks in a timely matter and/or reporting to management when assistance is needed to complete the tasks. - Report all insurance company or state requirements and denial trend changes to the Team Leader and Reimbursement Manager. - Participate in team and appeal meetings by sharing the details of cases worked. - Act as a backup on answering incoming telephone calls as needed. - May undertake special projects assigned by the Team Leader or Reimbursement Manager. - Ability to meet predetermined Productivity Goals based on the level of Appeal. - Ability to meet Quality Standard in place (90% or greater). - Other duties as assigned.
Job Locations
US
Category
Administrative/Clerical