Care Navigator - Billing Certificate Required

Care Navigator

We are excited to announce that currently we are looking for a 100% remote (work from home—WFH) contact Care Navigator 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.

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
  
  

Schedule

• Ability to work 40 hours per week under moderate supervision
  
  

Required Qualifications

• 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
• Medical Billing experience required
• Ability to interpret Explanation of Benefits (EOB)
• HIPPA trained
• Must reside in country where the job is posted.
  
  

Preferred Qualifications

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

[]

Note: This role is not eligible for visa sponsorship. Candidates must have authorization to work in the US without the need for sponsorship.

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 - $24.00 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.