Patient Support Medical/Biller Claims Processing Representative

IQVIA; Cleveland (OH); Remote; USD 60,000 - 80,000; Full time

Job summary

IQVIA recherche un Patient Support Medical/Biller Claims Processing Representative au niveau d'entrée. Ce rôle implique de traiter les demandes de remboursement médical et d'assurer une assistance aux patients. Les candidats doivent avoir un diplôme de fin d'études secondaires et des certifications spécifiques en facturation médicale et codage. Un environnement de travail à distance est proposé.

Qualifications

• Expérience en traitement des réclamations requise.
• Certification de facturation médicale et certification de codage nécessaires.
• Capacité d'interpréter les explications de bénéfices (EOB).

Responsibilities

• Recevoir et traiter les demandes de remboursement médical.
• Interpréter les EOB et déterminer si les demandes doivent être rejetées ou acceptées.
• Supporter les demandes des clients par téléphone, email, etc.

Skills

Organizational Skills

Customer Service Experience

Bilingual (English/Spanish)

Education

High School Diploma or equivalent

Medical Billing Certification

Coding Certification

HIPAA Certification

Job description

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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 (shifts available: 8:00 am - 5:00 pm EST, 9:00 am – 6:00 pm EST or, 10:00 am - 7:00 pm EST or, 11:00 am – 8:00pm EST) 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. The pay range for this role is $23.00 per hour. To be eligible for this position, you must reside in the same country where the job is located.

Seniority level

• Seniority level

  Entry level

Employment type

• Employment type

  Full-time

Job function

• Job function

  Accounting/Auditing and Finance

• Industries

  Hospitals and Health Care

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