location_onSt. Louis, MO, USA
watch_later Posted: Feb 22, 2024
Skills Required
Nice To Have skills
Job Description
We are excited to announce that currently we are looking for a 100% remote (work from home—WFH) contact Patient Support Medical Claims Processing Representative to join our team. In this position, you will provide payment assistance solutions such as co-pay cards or vouchers. The Patient Support Call Center Representative 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 (two shifts: 8:30 am EST – 5:30 pm EST or 11:00 am EST – 8:00pm EST) under moderate supervision
Minimum Education Experience:
- High School Diploma or equivalent
- Experience in claim processing required
- Medical Billing and Coding Certification required
- Ability to interpret Explanation of Benefits (EOB)
- HIPPA certified
- Customer Service Experience preferred
- Pharmacy Technician experience preferred
- The pay range for this role is $23.00 per hour.