Care Navigator - Billing Certificate Required

IQVIA Inc

New Providence, United States
Base: $23.00 - $24.00 ph; bonus/equity: not specif...
Fully remote
Claim vetting against business rules
Interpret explanation of benefits (eob)
Hipaa trained
IQVIA Inc is seeking a Care Navigator for a fully remote position to provide payment assistance solutions, primarily focused on claim processing. The ideal candidate should have a Medical Billing Certification, experience in claim processing, and the ability to interpret medical claims and documentation

Job Summary

  • Provide payment assistance solutions such as co-pay cards or vouchers.
  • Primary responsibilities involve receiving medical claims from HCPs or patients, ensuring adequate supporting documentation, interpreting EOB/CMS1500, vetting claims against program specific business rules, and determining payment or rejection.
  • Requires the ability to recognize operational challenges and suggest recommendations to management.

Matching Summary

Match Score: 85

IQVIA Inc is seeking a Care Navigator for a fully remote position to provide payment assistance solutions, primarily focused on claim processing. The ideal candidate should have a Medical Billing Certification, experience in claim processing, and the ability to interpret medical claims and documentation.

Salary

Base: $23.00 - $24.00 per hour; Bonus/Equity: Not specified; Benefits: Not specified

Skills & Requirements

Must-have

  • Claim vetting against business rules
  • Interpret Explanation of Benefits (EOB)
  • HIPAA trained
  • Work from home flexibility

Nice-to-have

  • Infusion billing experience
  • Hospital billing experience
  • Customer service experience
  • Pharmacy technician experience

Key Requirements

  • High School Diploma or equivalent
  • Experience in claim processing
  • Active Medical Billing Certification
  • Medical Billing experience
  • Ability to interpret EOB
  • HIPAA trained

Work Rights

Must reside in country where job is posted

Tailored Resume

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