HIPAA-Compliant Patient Billing & Claims Support Specialist

IQVIA; United States; Remote; USD 40,000 - 60,000; Full time

Job summary

IQVIA is seeking a claims processor to verify medical documentation and ensure claims are complete. You will interpret EOBs and CMS-1500 forms to determine approval or rejection according to program rules. The role includes assisting providers and patients via phone, email or fax, while maintaining HIPAA compliance.

The position emphasizes daily productivity and quality service in a fast-paced healthcare administration environment.

Responsibilities

• Receive medical claims from healthcare providers or patients and verify supporting documentation to ensure completeness.
• Interpret Explanation of Benefits (EOB) and CMS-1500 forms, then evaluate claims against program-specific business rules for approval or rejection.
• Provide support to customer inquiries via phone, email, or fax while maintaining HIPAA compliance and meeting daily productivity goals.

Job description

IQVIA is seeking a claims processor to verify medical documentation and ensure claims are complete. You will interpret EOBs and CMS-1500 forms to determine approval or rejection according to program rules. The role includes assisting providers and patients via phone, email or fax, while maintaining HIPAA compliance.

The position emphasizes daily productivity and quality service in a fast-paced healthcare administration environment.