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

About the role

This is a 100% remote contract position with IQVIA, managed by an external agency, with the potential to convert to a full-time IQVIA employee. As a Patient Support Medical Billing Representative, you'll provide payment assistance solutions such as co-pay cards or vouchers to patients. You'll receive medical claims from healthcare providers (HCPs) or patients, review supporting documentation, and vet each claim against program-specific business rules to determine whether it should be paid or rejected.

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 to determine approval or rejection
• Maintain exceptional organizational skills to manage daily workload
• Provide support to customer inquiries via phone, email, fax, or other communication channels
• Identify operational challenges and recommend solutions to management as needed
• Adhere to HIPAA guidelines
• Prioritize tasks effectively throughout the day
• Meet daily productivity and quota expectations
• Work 40 hours per 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 Billing license (Required)
• Experience in claim processing (Required)
• Ability to interpret EOBs (Required)
• Insurance verification experience (Required)
• Experience with payment postings (Required)
• Call center, customer service experience (inbound/outbound calls) (Required)
• Revenue cycle experience (Preferred)
• Proficiency in 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)

Pay

$23.00 per hour