Patient Support Medical/Biller Claims Processing Representative (Home-Based)

IQVIA; Charleston (SC); Remote; USD 60,000 - 80,000; Full time

Job summary

An established industry player is seeking a Patient Support Medical Claims Processing Representative for a remote role. This position involves assisting patients with payment solutions and processing medical claims. The ideal candidate will have strong organizational skills and experience in claim processing, along with necessary certifications. Join a dynamic team dedicated to improving patient outcomes through effective support solutions. This is an exciting opportunity to contribute to healthcare while working from the comfort of your home.

Qualifications

• Experience in claim processing is required.
• Medical Billing and Coding Certifications are mandatory.

Responsibilities

• Receive and vet medical claims from HCPs or patients.
• Ensure supporting documentation is adequate for claims processing.

Skills

Claim Processing

Customer Service

HIPAA Compliance

Bilingual (English/Spanish)

Education

High School Diploma or equivalent

Medical Billing Certification

Coding Certification

Job description

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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 (shifts available: 9:00 am – 6:00 pm EST or, 10:00 am - 7:00 pm ET or, 11:00 am EST – 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.

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.

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

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.

Seniority level

• Seniority level

  Not Applicable

Employment type

• Employment type

  Full-time

Job function

• Job function

  Accounting/Auditing and Finance

• Industries

  Pharmaceutical Manufacturing

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