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

IQVIA; Miami (FL); Remote; USD 80,000 - 100,000; Full time

Job summary

An established industry player is seeking a dedicated Patient Support Medical Claims Processing Representative for a remote contract role. This position offers the opportunity to process medical claims, verify documentation, and interpret EOBs, making a significant impact on patient support services. Ideal candidates will possess a high school diploma, relevant certifications in medical billing and coding, and experience in claims processing. Join a dynamic team that values diversity and inclusion, where your contributions will help deliver essential therapies to patients across the U.S.

Qualifications

• Experience in medical claims processing is required.
• Medical Billing and Coding certifications are mandatory.

Responsibilities

• Review medical claims ensuring proper documentation.
• Interpret EOBs and vet claims against business rules.
• Provide customer support via various channels.

Skills

Medical Claims Processing

Customer Service

EOB Interpretation

Bilingual (English/Spanish)

Education

High School Diploma or equivalent

Medical Billing Certification

Coding Certification

Job description

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Join to apply for the Patient Support Medical/Biller Claims Processing Representative (Home-Based) role at IQVIA.

Patient Support Medical Claims Processing Representative

Contract Remote Role – Location (Open to Remote US)

IQVIA is a global provider of commercial solutions helping biopharma, medical device, and diagnostic companies deliver therapies to patients. We support patient programs and have a large Commercial Sales & Medical Solutions (CSMS) organization with over 10,000 professionals worldwide. We are seeking a Patient Support Medical Claims Processing Representative for a remote, contract position, with potential for full-time conversion. Your role will involve processing medical claims, verifying documentation, interpreting EOB/CMS1500 forms, and determining claim outcomes.

Job Responsibilities:

1. Receive and review medical claims from HCPs or patients, ensuring proper documentation.
2. Interpret Explanation of Benefits (EOB) and vet claims against business rules.
3. Provide support to customers via phone, email, fax, or other channels.
4. Identify operational challenges and recommend improvements.
5. Work 40 hours per week, with shifts at 9:00 am – 6:00 pm EST, 10:00 am – 7:00 pm EST, or 11:00 am – 8:00 pm EST.

Minimum Education & Experience:

• High School Diploma or equivalent
• Experience in claim processing required
• Medical Billing Certification and Coding Certification required
• Ability to interpret EOBs
• HIPAA certified
• Customer Service and Pharmacy Technician experience preferred
• Bilingual (English/Spanish) preferred

The pay rate is $23/hour. Reside in the U.S. where the job is based to be eligible. IQVIA is an equal opportunity employer promoting diversity and inclusion.