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Medical Biller/Claims Processing - Patient Support Representative - Remote

Role overview

Qualifications

  • High School Diploma or equivalent
  • Experience in claim processing required
  • Medical Billing Certification required
  • Coding Certification required

Responsibilities

  • Receive medical claims from HCPs or patients and ensure adequate supporting documentation
  • Interpret the EOB/CMS1500 and vet claims against program specific business rules
  • Determine if claims should be paid or rejected
  • Provide support for customer requests via various means of contact

About the company

IQVIA logo

IQVIA

Contract Research Organizations (CRO)

IQVIA (NYSE:IQV) is a leading global provider of advanced analytics, technology solutions, and clinical research services to the life sciences industry. IQVIA creates intelligent connections across all aspects of healthcare through its analytics, transformative technology, big data resources and extensive domain expertise. IQVIA Connected Intelligence™ delivers powerful insights with speed and agility — enabling customers to accelerate the clinical development and commercialization of innovative medical treatments that improve healthcare outcomes for patients. With approximately 86,000 employees, IQVIA conducts operations in more than 100 countries. IQVIA is a global leader in protecting individual patient privacy. The company uses a wide variety of privacy-enhancing technologies and safeguards to protect individual privacy while generating and analyzing information on a scale that helps healthcare stakeholders identify disease patterns and correlate with the precise treatment path and therapy needed for better outcomes. IQVIA’s insights and execution capabilities help biotech, medical device and pharmaceutical companies, medical researchers, government agencies, payers and other healthcare stakeholders tap into a deeper understanding of diseases, human behaviors and scientific advances, in an effort to advance their path toward cures. To learn more, visit www.iqvia.com.

Company details

Company typeLarge
IndustryContract Research Organizations (CRO)
Company size10001

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Job description

Patient Support Medical Claims Processing ​Representative
 

Contract Remote Role – Location (Open to Remote US)

As the only global provider of commercial solutions, IQVIA understands what it takes to deliver nationally and internationally.  Our teams help biopharma, medical device and diagnostic companies get their therapies to the people who need them.  We help customers gain insight and access to their markets and ultimately demonstrate their product’s value to payers, physicians, and patients.  A significant part of our business is providing patient support programs on the behalf of our customers.  With the right experience, you can help provide support to patients in need of available therapies.

IQVIA has the world’s largest Commercial Sales & Medical Solutions (CSMS) organization dedicated to the launch and marketing of pharmaceutical and medical products.  With a focus on providing talent for patient support, field/inside sales, medical device support, clinical support, and medical affairs our CSMS division has 10,000+ field professionals in more than 30 countries addressing physician and patient needs.

We are excited to announce that currently we are looking for a 100% remote (work from home—WFH) contact Patient Support Medical Claims Processing Representative to join our team.  In this position, you will provide payment assistance solutions such as co-pay cards or vouchers. The Patient Support Call Center Representative is primarily responsible for receiving medical claims from HCPs or patients and vetting the claim against program specific business rules to determine if the claim should be paid or rejected.  This role will be a contract role with IQVIA managed by an external agency, with the opportunity to be converted to an IQVIA full-time employee.

Job Responsibilities:

  • Primary responsibilities involve receiving medical claims from HCPs or patients, ensuring the adequate supporting documentation has been provided, interpreting the EOB/CMS1500, vetting the claim against program specific business rules and ultimately determining if the claim should be paid or rejected
  • Exceptional organizational skills are required
  • May provide support as needed for customer requests via telephone, email, fax, or other available means of contact to the Support Center
  • Requires the ability to recognize operational challenges and suggest recommendations to management, as necessary
  • Ability to work 40 hours per week (shift available: 10:00am - 7:00pm ET) under moderate supervision

Minimum Education & Experience:

  • High School Diploma or equivalent
  • Experience in claim processing required
  • Medical Billing Certification required
  • Coding Certification required
  • Ability to interpret Explanation of Benefits (EOB)
  • HIPPA certified
  • Customer Service Experience preferred
  • Pharmacy Technician experience preferred
  • Bi-lingual (English/Spanish) preferred

To be eligible for this position, you must reside in the same country where the job is located.

IQVIA is an Equal Opportunity Employer. We cultivate a diverse corporate culture across the 100+ countries where we operate, celebrating and rewarding teamwork and inclusiveness. By embracing our differences, we create innovative solutions that are good for IQVIA, our clients, and the advancement of healthcare everywhere.  This role will be a contract role with IQVIA managed by an external agency, with the opportunity to be converted to an IQVIA full-time employee.

#LI-CES

#LI-REMOTE

#LI-DNP

IQVIA is a leading global provider of clinical research services, commercial insights and healthcare intelligence to the life sciences and healthcare industries. We create intelligent connections to accelerate the development and commercialization of innovative medical treatments to help improve patient outcomes and population health worldwide. Learn more at https://jobs.iqvia.com

IQVIA is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other status protected by applicable law. https://jobs.iqvia.com/eoe

IQVIA is committed to integrity in our hiring process and maintains a zero tolerance policy for candidate fraud. All information and credentials submitted in your application must be truthful and complete. Any false statements, misrepresentations, or material omissions during the recruitment process will result in immediate disqualification of your application, or termination of employment if discovered later, in accordance with applicable law. We appreciate your honesty and professionalism.

The potential base pay range for this role is $23.00 per hour. The actual base pay offered may vary based on a number of factors including job-related qualifications such as knowledge, skills, education, and experience; location; and/or schedule (full or part-time). Dependent on the position offered, incentive plans, bonuses, and/or other forms of compensation may be offered, in addition to a range of health and welfare and/or other benefits.

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MR

Marcus Rivera

Chief Revenue Officer

m.rivera@company.com
linkedin.com/in/marcusrivera
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