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

Atlanta, Georgia, United States

IQVIA Logo
Not SpecifiedCompensation
Entry Level & New Grad, Junior (1 to 2 years)Experience Level
Full TimeJob Type
UnknownVisa
Healthcare, PharmaceuticalsIndustries

Requirements

  • High School Diploma or equivalent
  • Experience in claim processing
  • Medical Billing Certification
  • Coding Certification
  • Ability to interpret Explanation of Benefits (EOB)
  • HIPAA certified
  • Customer Service Experience preferred
  • Pharmacy Technician experience preferred
  • Bi-lingual (English/Spanish) preferred
  • Ability to work 40 hours per week (shifts: 8:00am-5:00pm EST, 9:00am-6:00pm EST, 10:00am-7:00pm ET, or 11:00am-8:00pm EST) under moderate supervision
  • Exceptional organizational skills
  • Reside in the US (for remote eligibility)

Responsibilities

  • Receive medical claims from HCPs or patients
  • Ensure adequate supporting documentation has been provided
  • Interpret the EOB/CMS1500
  • Vet claims against program specific business rules
  • Determine if the claim should be paid or rejected
  • Provide support as needed for customer requests via telephone, email, fax, or other means
  • Recognize operational challenges and suggest recommendations to management as necessary

Skills

Medical Billing
Claims Processing
Patient Support
Co-pay Cards
Business Rules
Healthcare Claims
Call Center

IQVIA

Advanced analytics and clinical research services

About IQVIA

IQVIA provides advanced analytics, technology solutions, and clinical research services specifically for the life sciences industry. Their services utilize extensive data resources and technology to create connections within healthcare, allowing clients to gain insights that help speed up the development and marketing of new medical treatments. This process is facilitated by their IQVIA Connected Intelligence™ system, which offers quick and flexible insights. IQVIA stands out from competitors by focusing on patient privacy, employing various technologies to protect individual data. The company's goal is to enhance healthcare outcomes by supporting biotech, pharmaceutical, and medical device companies, as well as researchers and government agencies, in understanding diseases and advancing medical science.

Durham, North CarolinaHeadquarters
1998Year Founded
$3,526MTotal Funding
POST_IPO_EQUITYCompany Stage
Cybersecurity, Biotechnology, HealthcareIndustries
10,001+Employees

Risks

Rapid advancement of cancer vaccines may disrupt traditional clinical research models.
Proliferation of disparate technological solutions causes technology overload in clinical trials.
Generative AI technologies face challenges in adoption due to data privacy concerns.

Differentiation

IQVIA leverages advanced analytics and big data for life sciences solutions.
The company offers privacy-enhancing technologies to protect individual patient data.
IQVIA's AI Assistant provides rapid, actionable insights for healthcare and life sciences.

Upsides

Increased adoption of decentralized clinical trials enhances patient-centric study designs.
AI-driven drug discovery accelerates identification of potential drug candidates.
Expansion of telemedicine facilitates remote patient monitoring and data collection.

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