Care Navigator - Billing Certified & Coding Certified Required (Remote)

As the only global provider of commercial solutions, IQVIA understands what it takes to deliver nationally and internationally.  Our teams help biopharma, medical device and diagnostic companies get their therapies to the people who need them.  We help customers gain insight and access to their markets and ultimately demonstrate their product’s value to payers, physicians, and patients.  A significant part of our business is providing patient support programs on the behalf of our customers.  With the right experience, you can help provide support to patients in need of available therapies.

As the only global provider of commercial solutions, IQVIA understands what it takes to deliver nationally and internationally.  Our teams help biopharma, medical device and diagnostic companies get their therapies to the people who need them.  We help customers gain insight and access to their markets and ultimately demonstrate their product’s value to payers, physicians, and patients.  A significant part of our business is providing patient support programs on the behalf of our customers.  With the right experience, you can help provide support to patients in need of available therapies.

IQVIA has the world’s largest Commercial Sales & Medical Solutions (CSMS) organization dedicated to the launch and marketing of pharmaceutical and medical products.  With a focus on providing talent for patient support, field/inside sales, medical device support, clinical support, and medical affairs our CSMS division has 10,000 field professionals in more than 30 countries addressing physician and patient needs.

We are excited to announce that currently we are looking for a 100% remote (work from home—WFH) contact Care Navigator - Certified Biller and Certified Coder REQUIRED to join our team. In this position, you will provide payment assistance solutions such as co-pay cards or vouchers. 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 will be a contract role with IQVIA managed by an external agency, with the opportunity to be converted to an IQVIA full-time employee.

Job Responsibilities:

• Primary responsibilities involve receiving medical claims from HCPs or patients, ensuring the adequate supporting documentation has been provided, interpreting the EOB/CMS1500, vetting the claim against program specific business rules and ultimately determining if the claim should be paid or rejected
• Exceptional organizational skills are required
• May provide support as needed for customer requests via telephone, email, fax, or other available means of contact to the Support Center
• Requires the ability to recognize operational challenges and suggest recommendations to management, as necessary
• Ability to work 40 hours per week under moderate supervision

Minimum Education & Experience:

• High School Diploma or equivalent
• Experience in claim processing required
• Required to have active Medical Billing Certification with CEUs up to date or must be willing to get certification
• Required to have active Medical Coding Certification with CEUs up to date or must be willing to get certification
• Medical Billing experience required
• Infusion or Hospital Billing Experience Preferred
• Ability to interpret Explanation of Benefits (EOB)
• HIPPA trained
• Customer Service Experience preferred
• Pharmacy Technician experience preferred

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.

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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

The potential base pay range for this role is $49,000 - $50,000 annually. 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.

Salary : $49,000 - $50,000