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

Job Responsibilities

Receive medical claims from healthcare providers (HCPs) or patients and ensure all required supporting documentation is provided.

Interpret Explanation of Benefits (EOB) and CMS-1500 forms.

Evaluate claims against program-specific business rules todetermineapproval or rejection.

Maintain exceptional organizational skills to manage dailyworkload.

Provide support to customer inquiries via phone, email, fax, or other communication channels.

Identifyoperational challenges and recommend solutions to management as needed.

Adhere to HIPAA guidelines.

Prioritize tasks effectively throughout the day.

Meet daily productivity and quota expectations.

Work40 hoursper week under moderate supervision.

Minimum Education & Experience

High School Diploma or equivalent Required

Completion of Medical Billing Program or Medical Billing degree or Certified Medical BillinglicenseRequired

Experience in claim processing Required

Ability to interpret EOBs Required

Insurance verificationexperience Required

Experience with payment postings Required

Callcenter,customer service experience (inbound/outbound calls) Required

Revenue cycle experience Preferred

Proficiencyin Microsoft Office (Excel, Word, Outlook, Teams) Preferred

Experience with secondary and tertiary billing Preferred

Familiarity with complex insurance scenarios Preferred

Experience with multi-layered billing processes Preferred

The pay range for this role is $23.00 per hour.

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.

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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

IQVIA is committed to integrity in our hiring process and maintains a zero tolerance policy for candidate fraud. All information and credentials submitted in your application must be truthful and complete. Any false statements, misrepresentations, or material omissions during the recruitment process will result in immediate disqualification of your application, or termination of employment if discovered later, in accordance with applicable law. We appreciate your honesty and professionalism.

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.