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

Atlanta, Georgia, United States

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Not SpecifiedCompensation

Junior (1 to 2 years)Experience Level

Full TimeJob Type

UnknownVisa

Healthcare, Pharmaceuticals, Medical DevicesIndustries

Requirements

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 certified
Customer Service Experience preferred
Pharmacy Technician experience preferred
Bi-lingual (English/Spanish) preferred

Responsibilities

Receive medical claims from HCPs or patients
Ensure adequate supporting documentation is provided
Interpret EOB/CMS1500
Vetting claims against program-specific business rules
Determine if a claim should be paid or rejected
Provide support as needed for customer requests via telephone, email, fax, or other available means of contact
Recognize operational challenges and suggest recommendations to management, as necessary
Work 40 hours per week (shifts available: 9:00 am – 6:00 pm EST or, 10:00 am - 7:00 pm ET or, 11:00 am EST – 8:00pm EST) under moderate supervision

Skills

Key technologies and capabilities for this role

Claims ProcessingMedical BillingMedical CodingCo-pay AssistancePatient SupportEOB InterpretationBusiness Rules Vetting

Questions & Answers

Common questions about this position

Is this position remote?

Yes, this is a 100% remote (work from home—WFH) position open to remote US candidates.

What is the salary for this role?

This information is not specified in the job description.

What are the required qualifications for this position?

Requirements include a High School Diploma or equivalent, experience in claim processing, Medical Billing Certification, Coding Certification, ability to interpret Explanation of Benefits (EOB), and HIPAA certification.

What is the employment type for this role?

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

What are the work hours for this position?

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

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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