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QuadaxQU

Prior Authorization Representative

Quadax, Inc. is a premier healthcare revenue cycle management leader, dedicated to empowering organizations through innovative technology and expertise.

Quadax

Employee count: 501-1000

United States only

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Key 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.

Education/Experience:

  • High School diploma or GED
  • Previous 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

About the job

Apply before

Posted on

Job type

Full Time

Experience level

Education

High school

Location requirements

Hiring timezones

United States +/- 0 hours

About Quadax

Learn more about Quadax and their company culture.

View company profile

At the heart of what we do is a culture of commitment to client success and innovation. Quadax, Inc. has been a leading force in healthcare revenue cycle management for over 50 years, founded by Ralph Daugstrup and Tom Hockman in Cleveland, Ohio. Our mission is one of empowerment—empowering healthcare organizations to optimize their revenue cycles through cutting-edge technology, dedicated support, and unparalleled expertise. We specialize in crafting solutions that not only improve financial performance but also enhance the overall patient experience.

With a team of over 670 dedicated professionals, many with over a decade of experience, Quadax integrates innovative software solutions that adapt to the rapidly changing healthcare landscape. Our proprietary systems, like RemitMax and Decision Intelligence, exemplify how we leverage technology to ensure timely reimbursements that directly benefit our clients and their patients. We believe in maintaining a private entity status, allowing us to prioritize our clients’ needs without the pressures of shareholder expectations. At Quadax, we take pride in our values of integrity, teamwork, and dependability, working tirelessly to deliver measurable results and foster lasting relationships with our clients. As we look towards the future, our commitment remains steadfast; we are here to unlock financial success and redefine the standards of excellence in healthcare revenue cycle management.

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Quadax

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