Medical Biller – Claims Processing, Patient Support Representative

This is a fully remote position, open to applicants in Arizona, +1 more state.

📋 Description

• Collect medical claims from healthcare providers or patients and verify that all necessary supporting documentation is included.

• Analyze Explanation of Benefits (EOB) and CMS-1500 forms.

• Assess claims according to program-specific business rules to decide on approval or denial.

• Oversee daily workload and effectively prioritize tasks.

• Assist with customer inquiries through phone, email, fax, or other communication methods.

• Recognize operational issues and propose solutions to management.

• Comply with HIPAA regulations.

• Achieve daily productivity and quota targets.

• Commit to a 40-hour workweek under moderate supervision.

⛳️ Requirements

• High School Diploma or equivalent is required.

• Completion of a Medical Billing Program, Medical Billing degree, or Certified Medical Billing license is required.

• Prior experience in claim processing is required.

• Ability to interpret EOBs is required.

• Experience in insurance verification is required.

• Familiarity with payment postings is required.

• Call center or customer service experience with both inbound and outbound calls is required.

• Revenue cycle experience is preferred.

• Proficiency in Microsoft Office (Excel, Word, Outlook, Teams) is preferred.

• Experience with secondary and tertiary billing is preferred.

• Knowledge of complex insurance scenarios is preferred.

• Experience with multi-layered billing processes is preferred.

• Adherence to HIPAA regulations is necessary.

• Ability to work 40 hours per week under moderate supervision.

🏝️ Benefits

• Opportunities for career advancement.

• Potential for conversion to a full-time IQVIA employee.

• Health and welfare benefits may be available.

• Incentive plans, bonuses, and/or other types of compensation may be provided.

• Option to work from home.