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 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
• 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.
• #LI-CES
• #LI-Remote
• #LI-DNP
• 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.