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Medical Claims Support Specialist
2 months ago
Contract Remote Position - Open to Remote Work in the US
As a leading global provider of commercial solutions, IQVIA possesses the expertise required to facilitate the delivery of healthcare products and services on both national and international levels. Our dedicated teams assist biopharma, medical device, and diagnostic companies in ensuring their therapies reach the patients who need them.
We empower our clients to gain valuable insights and access to their respective markets, ultimately demonstrating the value of their products to payers, healthcare professionals, and patients alike.
A vital aspect of our operations involves offering patient support programs on behalf of our clients. With the right qualifications, you can play a crucial role in assisting patients in accessing necessary therapies.
IQVIA boasts the largest Commercial Sales & Medical Solutions (CSMS) organization globally, dedicated to the launch and marketing of pharmaceutical and medical products.
Our CSMS division, with over 10,000 field professionals across more than 30 countries, focuses on addressing the needs of both physicians and patients through specialized talent in patient support, field and inside sales, medical device assistance, clinical support, and medical affairs.
We are pleased to announce an opening for a fully remote (work from home) position for aMedical Claims Support Specialist
to join our dynamic team. In this role, you will provide payment assistance solutions, including co-pay cards and vouchers. The
Medical Claims Support Specialist
is primarily tasked with receiving medical claims from healthcare providers or patients and evaluating the claims against specific program guidelines to determine their eligibility for payment.
Key Responsibilities:
Primary duties include receiving medical claims from healthcare providers or patients, ensuring all necessary documentation is provided, interpreting the Explanation of Benefits (EOB) and CMS1500 forms, and assessing claims against program-specific criteria to decide on payment or rejection.
Exceptional organizational skills are essential.
May provide assistance for customer inquiries via various communication channels, including telephone, email, and fax.
Requires the ability to identify operational challenges and propose solutions to management as needed.
Ability to work 40 hours per week (available shifts: 9:00 am - 6:00 pm EST, 10:00 am - 7:00 pm EST, or 11:00 am - 8:00 pm EST) under moderate supervision.
Minimum Qualifications:
High School Diploma or equivalent
Experience in claims processing is required
Medical Billing Certification is mandatory
Coding Certification is required
Ability to interpret Explanation of Benefits (EOB)
HIPAA certification is necessary
Customer Service Experience is preferred
Pharmacy Technician experience is a plus
Bi-lingual (English/Spanish) is preferred
The compensation for this role is $23.00 per hour.
IQVIA
is an Equal Opportunity Employer. We foster a diverse corporate culture across the 100+ countries where we operate, celebrating and rewarding teamwork and inclusivity.
By embracing our differences, we create innovative solutions that benefit IQVIA, our clients, and the advancement of healthcare globally.
IQVIA is a premier global provider of advanced analytics, technology solutions, and clinical research services to the life sciences sector.
We are committed to pushing the boundaries of human science and data science to make a significant impact - assisting our clients in creating a healthier world.
