Care Navigator - Billing Certified & Coding Certification Required (Remote)

IQVIA; Atlanta (GA); Remote; USD 60,000 - 80,000; Part time

Job summary

A leading clinical research organization is seeking a fully remote Contact Care Navigator to handle payment assistance solutions, including claims processing. Candidates should have a High School Diploma and active medical billing and coding certifications. The role offers flexible hours and the potential for full-time conversion. Excellent organizational skills and a background in customer service are preferred.

Qualifications

• Experience in claim processing.
• Ability to interpret Explanation of Benefits (EOB).
• Infusion or Hospital Billing experience preferred.

Responsibilities

• Receive medical claims from HCPs or patients and ensure supporting documentation is complete.
• Support customer requests via telephone, email, or fax.
• Work approximately 40 hours per week under moderate supervision.

Skills

Organizational skills

Claim processing

Customer Service

HIPAA knowledge

Education

High School Diploma or equivalent

Active Medical Billing Certification

Active Medical Coding Certification

Job description

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 demonstrate their product’s value to payers, physicians, and patients. A significant part of our business involves providing patient support programs on behalf of our clients.

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 over 10,000 field professionals across more than 30 countries, addressing physician and patient needs.

We are currently seeking a fully remote (work from home) Contact Care Navigator - Certified Biller and Certified Coder REQUIRED to join our team. This contract role, managed by an external agency, offers the opportunity to be converted into a full-time IQVIA employee. The Care Navigator will provide payment assistance solutions such as co-pay cards or vouchers, and will be responsible for receiving medical claims from healthcare providers or patients, vetting claims against specific business rules, and determining whether claims should be paid or rejected.

Job Responsibilities:

1. Receive medical claims from HCPs or patients, ensure supporting documentation is complete, interpret EOB / CMS1500 forms, and vet claims against business rules.
2. Maintain exceptional organizational skills.
3. Support customer requests via telephone, email, fax, or other channels as needed.
4. Recognize operational challenges and suggest improvements to management.
5. Work approximately 40 hours per week under moderate supervision.

Minimum Education & Experience:

• High School Diploma or equivalent.
• Experience in claim processing.
• Active Medical Billing Certification with up-to-date CEUs, or willingness to obtain certification.
• Active Medical Coding Certification with up-to-date CEUs, or willingness to obtain certification.
• Medical Billing experience.
• Infusion or Hospital Billing experience (preferred).
• Ability to interpret Explanation of Benefits (EOB).
• HIPAA trained.
• Customer Service experience (preferred).
• Pharmacy Technician experience (preferred).

IQVIA is an Equal Opportunity Employer committed to diversity and inclusion. This role is a contract position with potential to convert to full-time employment.

LI-CES

LI-Remote

Learn more about IQVIA, a leading global provider of clinical research services, commercial insights, and healthcare intelligence, dedicated to improving patient outcomes worldwide.

The estimated base pay for this role is $24.00 per hour, with actual compensation depending on qualifications, location, and schedule. Additional incentives, bonuses, and benefits may also be offered.