Patient Support Medical Claims Processor

4 weeks ago


Crossville, Tennessee, United States IQVIA INC (US10) Full time
Job Title: Patient Support Medical Claims Processing Representative

We are seeking a highly skilled Patient Support Medical Claims Processing Representative to join our team at IQVIA INC (US10). As a key member of our team, you will play a critical role in providing payment assistance solutions to patients in need of available therapies.

Job Summary:

The Patient Support Medical Claims Processing Representative will be responsible for receiving medical claims from healthcare professionals (HCPs) or patients, ensuring the adequate supporting documentation has been provided, interpreting the Explanation of Benefits (EOB) and CMS1500, and determining if the claim should be paid or rejected.

Key Responsibilities:
  • Receive and process medical claims from HCPs or patients
  • Ensure supporting documentation is provided and accurate
  • Interpret EOB and CMS1500 to determine claim validity
  • Determine if claim should be paid or rejected
  • Provide exceptional customer service via telephone, email, fax, or other means of contact
  • Recognize operational challenges and suggest recommendations to management
Requirements:
  • High School Diploma or equivalent
  • Experience in claim processing required
  • Medical Billing Certification required
  • Coding Certification required
  • Ability to interpret EOB
  • HIPPA certified
  • Customer Service Experience preferred
  • Pharmacy Technician experience preferred
  • Bi-lingual (English/Spanish) preferred
What We Offer:

We offer a competitive salary range of $47,000 annually, with the potential for incentive plans, bonuses, and/or other forms of compensation. Additionally, we provide a range of health and welfare benefits.

IQVIA INC (US10) is an Equal Opportunity Employer, committed to providing equal employment opportunities for all, including veterans and candidates with disabilities.

We are committed to providing a safe and healthy work environment for our employees and customers. As such, we require all employees to meet specific requirements regarding COVID-19 vaccination status.



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