CARE NAVIGATOR
3 weeks ago
IQVIA has the world's largest Commercial Sales & Medical Solutions (CSMS) organization dedicated to the launch and marketing of pharmaceutical and medical products. With a focus on providing talent for patient support, field/inside sales, medical device support, clinical support, and medical affairs our CSMS division has 10,000+ field professionals in more than 30 countries addressing physician and patient needs.
We are excited to announce that currently we are looking for a 100% remote (work from home-WFH) contact Care Navigator - Certified Biller to join our team. In this position, you will provide payment assistance solutions such as co-pay cards or vouchers. The Care Navigator is primarily responsible for receiving medical claims from HCPs or patients and vetting the claim against program specific business rules to determine if the claim should be paid or rejected. 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.
Job Responsibilities:
- Primary responsibilities involve receiving medical claims from HCPs or patients, ensuring the adequate supporting documentation has been provided, interpreting the EOB/CMS1500, vetting the claim against program specific business rules and ultimately determining if the claim should be paid or rejected
- Exceptional organizational skills are required
- May provide support as needed for customer requests via telephone, email, fax, or other available means of contact to the Support Center
- Requires the ability to recognize operational challenges and suggest recommendations to management, as necessary
- Ability to work 40 hours per week : 8:00 am EST - 5:00 pm EST under moderate supervision
Minimum Education & Experience:
- High School Diploma or equivalent
- Experience in claim processing required
- Medical Billing Certification and experience required
- Infusion or Hospital Billing Experience Preferred
- Ability to interpret Explanation of Benefits (EOB)
- HIPPA trained
- Customer Service Experience preferred
- Pharmacy Technician experience preferred
The pay range for this role is $24.00 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
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IQVIA is a leading global provider of advanced analytics, technology solutions and clinical research services to the life sciences industry. We believe in pushing the boundaries of human science and data science to make the biggest impact possible - to help our customers create a healthier world. Learn more at https://jobs.iqvia.com
We are committed to providing equal employment opportunities for all, including veterans and candidates with disabilities. https://jobs.iqvia.com/eoe
IQVIA's ability to operate and provide certain services to customers and partners necessitates IQVIA and its employees meet specific requirements regarding COVID-19 vaccination status. https://jobs.iqvia.com/covid-19-vaccine-status
The potential base pay range for this role is 24.00 per hour. The actual base pay offered may vary based on a number of factors including job-related qualifications such as knowledge, skills, education, and experience; location; and/or schedule (full or part-time). Dependent on the position offered, incentive plans, bonuses, and/or other forms of compensation may be offered, in addition to a range of health and welfare and/or other benefits.
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