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Claims Processing Specialist for Patient Support Services
2 months ago
As a Claims Processing Specialist for Patient Support Services, you will play a crucial role in facilitating payment assistance solutions for patients. This position is fully remote, allowing you to work from the comfort of your home.
Key Responsibilities:
1. **Claims Management:** Receive and evaluate medical claims submitted by healthcare providers or patients, ensuring all necessary documentation is included.
2. **Claims Evaluation:** Interpret Explanation of Benefits (EOB) and CMS1500 forms, applying program-specific criteria to determine the eligibility of claims for payment.
3. **Customer Support:** Provide assistance to customers through various communication channels, addressing inquiries and resolving issues effectively.
4. **Operational Improvement:** Identify operational challenges and propose solutions to enhance efficiency and effectiveness in claims processing.
Qualifications:
- High School Diploma or equivalent is required.
- Proven experience in claims processing is essential.
- Medical Billing Certification and Coding Certification are mandatory.
- Familiarity with HIPAA regulations is required.
- Previous customer service experience is preferred, along with pharmacy technician experience.
- Bilingual candidates (English/Spanish) are encouraged to apply.
Work Schedule:
This role requires a commitment of 40 hours per week, with available shifts from 9:00 am to 8:00 pm EST.
Compensation:
The hourly pay for this position is $23.00.
Company Overview:
IQVIA is a leading global provider of advanced analytics, technology solutions, and clinical research services to the life sciences industry. We are dedicated to fostering a diverse corporate culture and creating innovative solutions that advance healthcare globally.
