Virtual Care Navigator - (med Billing Certificate Required)

IQVIA Inc

Base: $23.00 - $24.00 ph; bonus/equity: not specif...
Fully remote
Interpret explanation of benefits eob
Vet medical claims against business rules
Ensure adequate supporting documentation
IQVIA Inc is seeking a fully remote Virtual Care Navigator responsible for processing medical claims and providing payment assistance solutions. The ideal candidate should have experience in claim processing and hold an active Medical Billing Certification

Job Summary

  • The Care Navigator is primarily responsible for receiving medical claims from HCPs or patients and vetting the claim against program specific business rules to determine if the claim should be paid or rejected.
  • This role requires exceptional organizational skills and the ability to recognize operational challenges to suggest recommendations to management.
  • Candidates must reside in the country where the job is posted and have authorization to work in the US without visa sponsorship.

Matching Summary

Match Score: 85

IQVIA Inc is seeking a fully remote Virtual Care Navigator responsible for processing medical claims and providing payment assistance solutions. The ideal candidate should have experience in claim processing and hold an active Medical Billing Certification.

Salary

Base: $23.00 - $24.00 per hour; Bonus/Equity: Not specified; Benefits: Range of health and welfare and/or other benefits

Skills & Requirements

Must-have

  • Interpret Explanation of Benefits EOB
  • Vet medical claims against business rules
  • Ensure adequate supporting documentation

Nice-to-have

  • Infusion or Hospital Billing Experience
  • Customer Service Experience preferred
  • Pharmacy Technician experience preferred

Key Requirements

  • High School Diploma or equivalent
  • Active Medical Billing Certification with CEUs up to date
  • Experience in claim processing required
  • HIPPA trained
  • Must reside in country where job is posted

Work Rights

Must have authorization to work in the US without need for sponsorship

Tailored Resume

Cover Letter