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

Houston, Texas, United States

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Not SpecifiedCompensation

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)
Exceptional organizational skills
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
Reside in the US (for remote role)

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

Skills

Key technologies and capabilities for this role

Medical BillingClaims ProcessingPatient SupportCo-pay CardsVouchersBusiness RulesDocumentation ReviewCall Center

Questions & Answers

Common questions about this position

Is this position remote?

Yes, this is a 100% remote work from home position open to candidates in the US.

What are the required qualifications for this role?

Candidates need a High School Diploma or equivalent, experience in claim processing, Medical Billing Certification, Coding Certification, and the ability to interpret Explanation of Benefits (EOB). HIPAA certification is also required, with customer service, pharmacy technician experience, and bi-lingual skills (English/Spanish) preferred.

What are the work hours for this position?

The role requires 40 hours per week with available shifts: 8:00am - 5:00pm EST, 9:00am - 6:00pm EST, 10:00am - 7:00pm ET, or 11:00am - 8:00pm EST.

Is this a full-time position, and what is the employment type?

This is a full-time contract role managed by an external agency, with the opportunity to convert to an IQVIA full-time employee.

What skills make a strong candidate for this role?

Strong candidates will have claim processing experience, Medical Billing and Coding Certifications, ability to interpret EOBs, and HIPAA certification. Preferred qualifications include customer service or pharmacy technician experience and being bi-lingual in English/Spanish.

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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