Medical Biller/Claims Processing – Patient Support Representative

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

📋 Description

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

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

• Assess claims based on program-specific business rules to determine whether to approve or reject them.

• Effectively manage daily workload and prioritize tasks.

• Provide assistance to customer inquiries through phone, email, fax, or other communication methods.

• Identify operational challenges and propose solutions to management.

• Comply with HIPAA guidelines.

• Achieve daily productivity and quota targets.

• Work 40 hours per week with moderate supervision.

• Offer payment assistance options such as co-pay cards or vouchers to patients.

⛳️ Requirements

• High School Diploma or equivalent is required.

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

• Experience in claim processing is mandatory.

• Ability to interpret EOBs is required.

• Experience in insurance verification is necessary.

• Familiarity with payment postings is required.

• Call center or customer service experience (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.

• Understanding of complex insurance scenarios is preferred.

• Experience with multi-layered billing processes is preferred.

• Adherence to HIPAA guidelines is essential.

• Ability to work 40 hours per week is required.

🏝️ Benefits

• Opportunities for career development.

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

• Health and welfare benefits and/or other offerings may be available.

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