Medical Biller/Claims Processing - Patient Support Representative (Home-Based)
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What you'll do
- Receive medical claims from healthcare providers (HCPs) or patients and ensure all required supporting documentation is provided.
- Interpret Explanation of Benefits (EOB) and CMS-1500 forms.
- Evaluate claims against program-specific business rules to determine approval or rejection.
- Maintain exceptional organizational skills to manage daily workload.
- Provide support to customer inquiries via phone, email, fax, or other communication channels.
- Identify operational challenges and recommend solutions to management as needed.
- Adhere to HIPAA guidelines.
- Prioritize tasks effectively throughout the day.
- Meet daily productivity and quota expectations.
- Work 40 hours per week under moderate supervision.
What they're looking for
- High School Diploma or equivalent Required
- Completion of Medical Billing Program or Medical Billing degree or Certified Medical Billing license Required
- Experience in claim processing Required
- Ability to interpret EOBs Required
- Insurance verification experience Required
- Experience with payment postings Required
- Call center, customer service experience (inbound/outbound calls) Required
Nice to have
- Revenue cycle experience Preferred
- Proficiency in Microsoft Office (Excel, Word, Outlook, Teams) Preferred
- Experience with secondary and tertiary billing Preferred
- Familiarity with complex insurance scenarios Preferred
- Experience with multi-layered billing processes Preferred
Summarised by NextRaise from the employer’s description, which follows in full below.
Full description from employer
Patient Support Medical Billing Representative
Remote Role – Location (Open to Remote US)
At IQVIA, we are driven by a shared purpose: to improve patients’ lives through innovative healthcare solutions. As a global leader in commercial services, we bring life-changing therapies and support programs to the people who need them most. Our workplace is rooted in belonging, collaboration, and continuous improvement—where every team member is empowered to make an impact.
As a Patient Support Medical Billing Representative, you’ll be part of a team that delivers meaningful assistance to patients through co-pay cards, vouchers, and claims support. We invest in your success with career development opportunities and a culture that values client focus, flawless execution, teamwork, integrity, and results.
We are excited to announce an opening for a 100% remote (work from home) Patient Support Medical Billing Representative to join our team! In this role, you will provide payment assistance solutions such as co-pay cards or vouchers to patients. Your primary responsibility will be to receive medical claims from healthcare providers (HCPs) or patients, review supporting documentation, and vet each claim against program-specific business rules to determine whether it should be paid or rejected.
Job Responsibilities
Receive medical claims from healthcare providers (HCPs) or patients and ensure all required supporting documentation is provided.
Interpret Explanation of Benefits (EOB) and CMS-1500 forms.
Evaluate claims against program-specific business rules to determine approval or rejection.
Maintain exceptional organizational skills to manage daily workload.
Provide support to customer inquiries via phone, email, fax, or other communication channels.
Identify operational challenges and recommend solutions to management as needed.
Adhere to HIPAA guidelines.
Prioritize tasks effectively throughout the day.
Meet daily productivity and quota expectations.
Work 40 hours per week under moderate supervision.
Minimum Education & Experience
High School Diploma or equivalent Required
Completion of Medical Billing Program or Medical Billing degree or Certified Medical Billing license Required
Experience in claim processing Required
Ability to interpret EOBs Required
Insurance verification experience Required
Experience with payment postings Required
Call center, customer service experience (inbound/outbound calls) Required
Revenue cycle experience Preferred
Proficiency in Microsoft Office (Excel, Word, Outlook, Teams) Preferred
Experience with secondary and tertiary billing Preferred
Familiarity with complex insurance scenarios Preferred
Experience with multi-layered billing processes Preferred
The pay range for this role is $23.00 per hour.
IQVIA is an Equal Opportunity Employer. We cultivate a diverse corporate culture across the 100+ countries where we operate, celebrating and rewarding teamwork and inclusiveness. By embracing our differences, we create innovative solutions that are good for IQVIA, our clients, and the advancement of healthcare everywhere. 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.
#LI-CES
#LI-Remote
#LI-DNP
IQVIA is a leading global provider of clinical research services, commercial insights and healthcare intelligence to the life sciences and healthcare industries. We create intelligent connections to accelerate the development and commercialization of innovative medical treatments to help improve patient outcomes and population health worldwide. Learn more at https://jobs.iqvia.com
IQVIA is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other status protected by applicable law. https://jobs.iqvia.com/eoe
IQVIA is committed to integrity in our hiring process and maintains a zero tolerance policy for candidate fraud. All information and credentials submitted in your application must be truthful and complete. Any false statements, misrepresentations, or material omissions during the recruitment process will result in immediate disqualification of your application, or termination of employment if discovered later, in accordance with applicable law. We appreciate your honesty and professionalism.
The potential base pay range for this role is $23.00 per hour. The actual base pay offered may vary based on a number of factors including job-related qualifications such as knowledge, skills, education, and experience; location; and/or schedule (full or part-time). Dependent on the position offered, incentive plans, bonuses, and/or other forms of compensation may be offered, in addition to a range of health and welfare and/or other benefits.Company
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