Care Navigator - Certified Biller (Remote) - Patient Support and Medical Claims Processing

Job Summary

IQVIA, a global leader in clinical research services, commercial insights, and healthcare intelligence, is seeking a highly skilled and detail-oriented Care Navigator - Certified Biller to join our team on a remote basis. As a critical member of our Commercial Sales & Medical Solutions (CSMS) organization, you will play a vital role in providing payment assistance solutions to patients in need of available therapies. This is a contract role with the opportunity to be converted to a full-time employee.

About IQVIA

IQVIA is the only global provider of commercial solutions, helping biopharma, medical device, and diagnostic companies get their therapies to the people who need them. Our teams provide patient support programs, field and inside sales, medical device support, clinical support, and medical affairs solutions to customers worldwide. With a presence in over 100 countries, we cultivate a diverse corporate culture that celebrates teamwork, inclusiveness, and innovation.

Job Responsibilities

As a Care Navigator - Certified Biller, your primary responsibilities will include:

• Receiving medical claims from healthcare providers (HCPs) or patients and vetting them against program-specific business rules to determine if the claim should be paid or rejected
• Ensuring adequate supporting documentation has been provided and interpreting Explanation of Benefits (EOB) and CMS1500 forms
• Providing support to customers via telephone, email, fax, or other available means of contact to the Support Center
• Recognizing operational challenges and suggesting recommendations to management as necessary
• Working 40 hours per week under moderate supervision

Requirements and Qualifications

Essential Qualifications:

• High School Diploma or equivalent required
• Active Medical Billing Certification or willingness to obtain certification
• Experience in claim processing and medical billing
• Ability to interpret Explanation of Benefits (EOB) and CMS1500 forms
• HIPAA training

Preferred Qualifications:

• Infusion or Hospital Billing Experience
• Customer Service Experience
• Pharmacy Technician experience

Skills and Competencies

To succeed in this role, you will need:

• Exceptional organizational and time management skills
• Strong attention to detail and analytical skills
• Excellent communication and customer service skills
• Ability to work independently in a remote setting
• Strong problem-solving and critical thinking skills

Career Growth Opportunities and Learning Benefits

IQVIA is committed to the growth and development of our employees. As a Care Navigator - Certified Biller, you will have opportunities to:

• Develop your skills and expertise in medical billing and claims processing
• Advance your career within IQVIA's Commercial Sales & Medical Solutions organization
• Participate in training and development programs to enhance your knowledge and skills
• Collaborate with a diverse and talented team of professionals

Work Environment and Company Culture

IQVIA is a global company with a presence in over 100 countries. Our company culture is built on:

• Diversity, equity, and inclusion
• Teamwork and collaboration
• Innovation and creativity
• Customer-centricity and patient focus

Compensation, Perks, and Benefits

IQVIA offers a competitive salary and benefits package, including:

• Competitive base pay range: $46,800.00 - $82,600.00 per year
• Incentive plans, bonuses, and other forms of compensation
• Comprehensive health and welfare benefits
• Opportunities for professional growth and development

Conclusion

If you are a motivated and detail-oriented individual with experience in medical billing and claims processing, we encourage you to apply for this exciting opportunity as a Care Navigator - Certified Biller. As a remote employee, you will have the flexibility to work from home and be part of a dynamic team that is making a difference in the lives of patients worldwide.

Take the next step and apply now to join our team!