Medical Biller/Claims Processing - Patient Support Representative (Home-Based)

Medical Biller/Claims Processing - Patient Support Representative (Home-Based)

Atlanta, United States of America | Home-based

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 improvementwhere 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. This is a contract position with IQVIA, managed by an external agency, with the potential to convert to a full-time IQVIA employee.

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.