Join our dynamic team at Quadrant Health Group! Quadrant Billing Solutions, a proud member of the Quadrant Health Group, is seeking a passionate and dedicated Claims Specialist to join our growing team. You will play a vital role focused on ensuring that healthcare services are delivered efficiently and effectively.
Why Join Quadrant Health Group?
- Competitive salary commensurate with experience.
- Comprehensive benefits package, including medical, dental, and vision insurance.
- Paid time off, sick time and holidays.
- Opportunities for professional development and growth.
- A supportive and collaborative work environment.
- A chance to make a meaningful impact on the lives of our clients.
Compensation: $18 - $24 per hour - Full-time
What You'll Do:
The ideal candidate is organized, persistent, and results-driven, with deep knowledge of out-of-network billing for Substance Use Disorder (SUD) and Mental Health (MH) services. You'll join a high-performing team focused on maximizing collections, reducing aging A/R, and ensuring every dollar is pursued.
Major Tasks, Duties and Responsibilities:
- Proactively follow up on unpaid and underpaid claims for Detox, Residential, PHP, and IOP levels of care.
- Manage 500-700 claims per week, prioritizing efficiency and accuracy.
- Handle 4-5 hours of phone time per day with strong communication skills.
- Communicate with payers via phone, portals, and written correspondence to resolve billing issues.
- Identify trends in denials and underpayments and escalate systemic issues.
- Dispute and overturn wrongly denied claims.
- Update and track claims using CMD (CollaborateMD) and internal task systems.
- Follow QBS workflows using Google Drive, Docs, Sheets, and Kipu EMR.
- Maintain professional and timely communication with internal teams and facility partners.
Bonus Experience (Not Required):
- Handling refund requests and appeals.
- Preparing and submitting level 1-3 appeals (e.g., medical necessity, low pay, timely filing).
- Gathering and submitting medical records for appeal support.
- Working with utilization review (UR) or clinical teams.
- Familiarity with ASAM and MCG medical necessity criteria.
- Exposure to payment posting, authorization reviews, or credentialing.
What You'll Bring:
- Minimum 1 year of SUD/MH billing and claims follow-up experience (required).
- High School Diploma or equivalent, associate or bachelor's degree (preferred).
- Strong understanding of insurance verification, EOBs, and RCM workflows.
- Familiarity with major payers: BCBS, Cigna, Aetna, UHC, Optum, TriWest.
- Experience overturning insurance denials is a strong plus.
- Proficient in CMD (CollaborateMD) and Kipu EMR (strongly preferred).
- Excellent written and verbal communication skills.
- Highly organized, detail-oriented, and capable of managing multiple priorities.
Why Join Quadrant Billing Solutions?
- Rapid career growth in a mission-driven, niche billing company.
- Collaborate with clinical and billing experts who understand behavioral health.
- Join a tight-knit, supportive team culture.
- Gain opportunities for leadership advancement as the company scales.
Compensation details: 18-24 Hourly Wage
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