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

IQVIA; Nashville (TN); Remote; USD 10,000 - 60,000; Full time

Job summary

An established industry player is looking for a dedicated Remote Patient Support Medical Claims Processing Representative to join their team. This role involves handling payment assistance solutions, verifying medical claims, and ensuring accurate documentation. The ideal candidate will possess strong organizational skills and the ability to interpret medical billing documents. This contract position offers the potential to transition into a full-time role, providing an excellent opportunity for growth within a leading company in the healthcare sector. If you're passionate about supporting patients and have the required certifications, this position could be a perfect fit for you.

Qualifications

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

Responsibilities

• Receive and review medical claims and ensure documentation is complete.
• Support customer requests via phone, email, and fax.

Skills

Claim Processing

Customer Service

HIPAA Compliance

Bilingual (English/Spanish)

Education

High School Diploma

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)

IQVIA, as the world's largest provider of commercial solutions, helps biopharma, medical device, and diagnostic companies deliver therapies to patients. Our patient support programs assist patients in accessing therapies. Our CSMS organization, with over 10,000 professionals in more than 30 countries, focuses on launching and marketing pharmaceutical and medical products.

We are seeking a Remote Patient Support Medical Claims Processing Representative to handle payment assistance solutions like co-pay cards or vouchers. The role involves receiving medical claims from HCPs or patients, verifying documentation, interpreting EOB/CMS1500, and determining claim payment or rejection. This is a contract role with potential to become a full-time IQVIA employee.

Job Responsibilities:

• Receive and review medical claims, ensure supporting documentation is complete, interpret EOB/CMS1500, and decide on claim payment or rejection.
• Maintain excellent organizational skills.
• Support customer requests via phone, email, fax, or other channels.
• Identify operational challenges and suggest improvements.
• Work 40 hours per week during shifts from 9:00 am – 6:00 pm EST, 10:00 am – 7:00 pm EST, or 11:00 am – 8:00 pm 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).
• HIPAA certification.
• Customer Service experience preferred.
• Pharmacy Technician experience preferred.
• Bilingual (English/Spanish) preferred.

The pay rate is $23.00 per hour. Applicants must reside in the same country as the job location.

IQVIA is an Equal Opportunity Employer promoting diversity and inclusiveness. This contract role may convert to a full-time position.

Learn more at https://jobs.iqvia.com.