Care Navigator - Billing Certificate Required

IQVIA • New Providence, NJ

5d • $23 - $24 • Remote

About The Position

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.

Requirements

• 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.

Nice To Haves

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

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

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED
• Number of Employees: 5,001-10,000 employees