Medical Biller, Claims Processing – Patient Support Representative

This is a fully remote position, open to applicants in Florida, +8 more states.

📋 Description

• Receive medical claims from healthcare providers or patients, ensuring that all necessary supporting documentation is included.

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

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

• Provide assistance to customer inquiries through various communication channels, including phone, email, and fax.

• Identify operational issues and propose solutions to management as required.

• Comply with HIPAA regulations.

• Effectively prioritize tasks throughout the day.

• Achieve daily productivity and quota goals.

• Work 40 hours per week with moderate supervision.

⛳️ Requirements

• High School Diploma or equivalent is required.

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

• Experience in claim processing is required.

• Ability to interpret EOBs is required.

• Insurance verification experience is required.

• Experience with payment postings is required.

• Call center and customer service experience (inbound/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.

• Familiarity with complex insurance situations is preferred.

• Experience with multi-layered billing processes is preferred.

• Ability to work 40 hours per week is required.

• Adherence to HIPAA guidelines is necessary.

🏝️ Benefits

• Opportunities for career development.

• Possibility of transitioning to a full-time IQVIA employee.

• Potential for incentive plans, bonuses, and/or other forms of compensation.

• Health and welfare benefits and/or other perks may be offered.