2,740 Claims Processing jobs in the United States

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.
As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.
**Position Summary**
Our Claims team is looking for experienced Claims Processors to join our fast-paced Claims Department. As a Claims Processor, you will be responsible for accurate and efficient adjudication of paper claims from electronic images in a production environment.
Primary Responsibilities of the Claims Processor include:
+ Outbound calls to Members and/or Providers for verification of information
+ Processing and adjudicating paper claims.
+ Maintaining integrity of claims receipts in accordance with standard claims operating and adjudication procedures.
+ Accurately resolving pending claims using state and federal regulations and specific health plan criteria.
+ Working within turnaround times to meet client performance guarantees for claims processing.
+ Meeting productivity and accuracy standards.
**Required Qualifications**
+ 1 year of work experience with a progressive trend in responsibility and accountability, preferably in a Healthcare setting
+ Excellent verbal and written communication skills
+ In-depth experience working with Microsoft Office Suite products
+ This position is fully remote, but must be able to work the Arizona Time Zone hours.
**Preferred Qualifications**
+ Previous PBM Experience
+ Strong typing skills with speed and accuracy
+ Team-oriented while also able to pursue personal and departmental production goals daily
+ Ability to stay organized in a multi-demand and multi-priority environment
+ Ability to work overtime as necessary
+ Strong time management skills with ability to meet production goals
**Education**
High School Diploma or equivalent GED
**Anticipated Weekly Hours**
40
**Time Type**
Full time
**Pay Range**
The typical pay range for this role is:
$17.00 - $28.46
This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.
Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.
**Great benefits for great people**
We take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:
+ **Affordable medical plan options,** a **401(k) plan** (including matching company contributions), and an **employee stock purchase plan** .
+ **No-cost programs for all colleagues** including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
+ **Benefit solutions that address the different needs and preferences of our colleagues** including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.
For more information, visit anticipate the application window for this opening will close on: 07/21/2025
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
We are an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.

**Details**
+ **Department:** Billing/Claims
+ **Schedule:** Full-Time, Days Mon. - Fri. 8AM-5PM
+ **Hospital:** Ascension St. Vincent's
+ **Location:** 3 Shircliff Way Jacksonville, Florida 32204-4757 United States
**Benefits**
Paid time off (PTO)
Various health insurance options & wellness plans
Retirement benefits including employer match plans
Long-term & short-term disability
Employee assistance programs (EAP)
Parental leave & adoption assistance
Tuition reimbursement
Ways to give back to your community
_Benefit options and eligibility vary by position. Compensation varies based on factors including, but not limited to, experience, skills, education, performance and salary range at the time of the offer._
**Responsibilities**
Prepare and issues bills for reimbursement to individual and third party payers in an out-patient or medical office environment.
+ Prepare insurance claims for submission to third party payers and/or responsible parties.
+ Review claims for accuracy, including proper diagnosis and procedure codes.
+ Review claim rejections and communicates with payers to resolve billing issues.
+ Prepare and review routine billing reports.
+ Recommend process improvements based on findings.
+ Respond to complex telephone and written inquiries from patients and/or third party payers and physician practices.
**Requirements**
Education:
+ High School diploma equivalency OR 1 year of applicable cumulative job specific experience required.
+ Note: Required professional licensure/certification can be used in lieu of education or experience, if applicable.
**Additional Preferences**
No additional preferences.
**Why Join Our Team**
Ascension St. Vincent's is expanding in the fastest-growing county in Northeast Florida with the addition of a fourth regional hospital, Ascension St. Vincent's St. Johns County. Serving Northeast Florida and Southeast Georgia, Ascension St. Vincent's has been providing caregivers in every discipline a rewarding career in healthcare since 1873.
Ascension is a leading non-profit, faith-based national health system made up of over 134,000 associates and 2,600 sites of care, including more than 140 hospitals and 40 senior living communities in 19 states.
Our Mission, Vision and Values encompass everything we do at Ascension. Every associate is empowered to give back, volunteer and make a positive impact in their community. Ascension careers are more than jobs; they are opportunities to enhance your life and the lives of the people around you.
**Equal Employment Opportunity Employer**
Ascension provides Equal Employment Opportunities (EEO) to all associates and applicants for employment without regard to race, color, religion, sex/gender, sexual orientation, gender identity or expression, pregnancy, childbirth, and related medical conditions, lactation, breastfeeding, national origin, citizenship, age, disability, genetic information, veteran status, marital status, all as defined by applicable law, and any other legally protected status or characteristic in accordance with applicable federal, state and local laws.
For further information, view the EEO Know Your Rights (English) ( poster or EEO Know Your Rights (Spanish) ( poster.
As a military friendly organization, Ascension promotes career flexibility and offers many benefits to help support the well-being of our military families, spouses, veterans and reservists. Our associates are empowered to apply their military experience and unique perspective to their civilian career with Ascension.
Pay Non-Discrimination Notice ( note that Ascension will make an offer of employment only to individuals who have applied for a position using our official application. Be on alert for possible fraudulent offers of employment. Ascension will not solicit money or banking information from applicants.
**E-Verify Statement**
This employer participates in the Electronic Employment Verification Program. Please click the E-Verify link below for more information.
E-Verify (

Commercial Claims Processing Associate, Claims Examiner Headquarters Office, 625 State Street, Schenectady, New York, United States of America ? Rochester Office, 20 S. Clinton Ave, Rochester, New York, United States of America Req #2572 Friday, June 20, 2025 At MVP Health Care, we're on a mission to create a healthier future for everyone - which requires innovative thinking and continuous improvement. To achieve this, we're looking for a Medical Claims Examiner to join #TeamMVP. This is the opportunity for you if you have a passion for analyzing information. **What's in it for you:** + Growth opportunities to uplevel your career + A people-centric culture embracing and celebrating diverse perspectives, backgrounds, and experiences within our team + Competitive compensation and comprehensive benefits focused on well-being + An opportunity to shape the future of health care by joining a team recognized as a **Best Place to Work** for and one of the **Best Companies to Work For in New York** **Qualifications you'll** **bring:** + High School Diploma required. Associate degree in health, Business or related field preferred + The availability to work Full-Time, Virtual + Previous related health care experience required + Knowledge of CPT, HCPCS, ICD-9-CM coding systems and Medical terminology preferred. + Strong PC skills required, Microsoft Windows experience highly desired. Strong attention to detail. + Curiosity to foster innovation and pave the way for growth + Humility to play as a team + Commitment to being the difference for our customers in every interaction **Your key responsibilities:** + Using a PC /Microsoft Window environment, adjudicates claims with the aid of the Facets and Macess Systems. + Reviews and ensures the accuracy of all provider, member and claim line information for all claims for which the examiner is responsible. + Knowledge of Facets and Macess systems strongly preferred, but not required. + Reviews and ensures the accuracy of all changes to claim line information based on information received from other departments and in accord with available benefit information. + Is responsible for the timely and accurate adjudication of claims that are suspended to other MVP departments for benefit and/or authorization determination. + Meets or exceeds department quality and work management standards for claims adjudication. + Successfully completes a course of comprehensive formal training in all areas of benefits determination, system navigation, and MVP policy. + Suspends, investigates and resolves claim issues by coordinating with appropriate departments, based on criteria set by those departments. + Handles inquiries regarding suspended claims from other departments and identifies trends in suspensions based on these inquiries and other feedback. + Keeps abreast of all benefit changes. + Contribute to our humble pursuit of excellence by performing various responsibilities that may arise, reflecting our collective goal of enhancing healthcare delivery and being the difference for the customer. **Where you'll be:** Virtual within Rochester, NY or Schenectady, NY **Pay Transparency** MVP Health Care is committed to providing competitive employee compensation and benefits packages. The base pay range provided for this role reflects our good faith compensation estimate at the time of posting. MVP adheres to pay transparency nondiscrimination principles. Specific employment offers and associated compensation will be extended individually based on several factors, including but not limited to geographic location; relevant experience, education, and training; and the nature of and demand for the role. We do not request current or historical salary information from candidates. **MVP's Inclusion Statement** At MVP Health Care, we believe creating healthier communities begins with nurturing a healthy workplace. As an organization, we strive to create space for individuals from diverse backgrounds and all walks of life to have a voice and thrive. Our shared curiosity and connectedness make us stronger, and our unique perspectives are catalysts for creativity and collaboration. MVP is an equal opportunity employer and recruits, employs, trains, compensates, and promotes without discrimination based on race, color, creed, national origin, citizenship, ethnicity, ancestry, sex, gender identity, gender expression, religion, age, marital status, personal appearance, sexual orientation, family responsibilities, familial status, physical or mental disability, handicapping condition, medical condition, pregnancy status, predisposing genetic characteristics or information, domestic violence victim status, political affiliation, military or veteran status, Vietnam-era or special disabled Veteran or other legally protected classifications. To support a safe, drug-free workplace, pre-employment criminal background checks and drug testing are part of our hiring process. If you require accommodations during the application process due to a disability, please contact our Talent team at (email protected) . **Other details** + Job Family Claims/Operations + Pay Type Hourly + Min Hiring Rate $20.00 + Max Hiring Rate $23.50 + Headquarters Office, 625 State Street, Schenectady, New York, United States of America + Rochester Office, 20 S. Clinton Ave, Rochester, New York, United States of America <

Commercial Claims Processing Associate, Claims Examiner Headquarters Office, 625 State Street, Schenectady, New York, United States of America ? Rochester Office, 20 S. Clinton Ave, Rochester, New York, United States of America Req #2572 Friday, June 20, 2025 At MVP Health Care, we're on a mission to create a healthier future for everyone - which requires innovative thinking and continuous improvement. To achieve this, we're looking for a Medical Claims Examiner to join #TeamMVP. This is the opportunity for you if you have a passion for analyzing information. **What's in it for you:** + Growth opportunities to uplevel your career + A people-centric culture embracing and celebrating diverse perspectives, backgrounds, and experiences within our team + Competitive compensation and comprehensive benefits focused on well-being + An opportunity to shape the future of health care by joining a team recognized as a **Best Place to Work** for and one of the **Best Companies to Work For in New York** **Qualifications you'll** **bring:** + High School Diploma required. Associate degree in health, Business or related field preferred + The availability to work Full-Time, Virtual + Previous related health care experience required + Knowledge of CPT, HCPCS, ICD-9-CM coding systems and Medical terminology preferred. + Strong PC skills required, Microsoft Windows experience highly desired. Strong attention to detail. + Curiosity to foster innovation and pave the way for growth + Humility to play as a team + Commitment to being the difference for our customers in every interaction **Your key responsibilities:** + Using a PC /Microsoft Window environment, adjudicates claims with the aid of the Facets and Macess Systems. + Reviews and ensures the accuracy of all provider, member and claim line information for all claims for which the examiner is responsible. + Knowledge of Facets and Macess systems strongly preferred, but not required. + Reviews and ensures the accuracy of all changes to claim line information based on information received from other departments and in accord with available benefit information. + Is responsible for the timely and accurate adjudication of claims that are suspended to other MVP departments for benefit and/or authorization determination. + Meets or exceeds department quality and work management standards for claims adjudication. + Successfully completes a course of comprehensive formal training in all areas of benefits determination, system navigation, and MVP policy. + Suspends, investigates and resolves claim issues by coordinating with appropriate departments, based on criteria set by those departments. + Handles inquiries regarding suspended claims from other departments and identifies trends in suspensions based on these inquiries and other feedback. + Keeps abreast of all benefit changes. + Contribute to our humble pursuit of excellence by performing various responsibilities that may arise, reflecting our collective goal of enhancing healthcare delivery and being the difference for the customer. **Where you'll be:** Virtual within Rochester, NY or Schenectady, NY **Pay Transparency** MVP Health Care is committed to providing competitive employee compensation and benefits packages. The base pay range provided for this role reflects our good faith compensation estimate at the time of posting. MVP adheres to pay transparency nondiscrimination principles. Specific employment offers and associated compensation will be extended individually based on several factors, including but not limited to geographic location; relevant experience, education, and training; and the nature of and demand for the role. We do not request current or historical salary information from candidates. **MVP's Inclusion Statement** At MVP Health Care, we believe creating healthier communities begins with nurturing a healthy workplace. As an organization, we strive to create space for individuals from diverse backgrounds and all walks of life to have a voice and thrive. Our shared curiosity and connectedness make us stronger, and our unique perspectives are catalysts for creativity and collaboration. MVP is an equal opportunity employer and recruits, employs, trains, compensates, and promotes without discrimination based on race, color, creed, national origin, citizenship, ethnicity, ancestry, sex, gender identity, gender expression, religion, age, marital status, personal appearance, sexual orientation, family responsibilities, familial status, physical or mental disability, handicapping condition, medical condition, pregnancy status, predisposing genetic characteristics or information, domestic violence victim status, political affiliation, military or veteran status, Vietnam-era or special disabled Veteran or other legally protected classifications. To support a safe, drug-free workplace, pre-employment criminal background checks and drug testing are part of our hiring process. If you require accommodations during the application process due to a disability, please contact our Talent team at (email protected) . **Other details** + Job Family Claims/Operations + Pay Type Hourly + Min Hiring Rate $20.00 + Max Hiring Rate $23.50 + Headquarters Office, 625 State Street, Schenectady, New York, United States of America + Rochester Office, 20 S. Clinton Ave, Rochester, New York, United States of America <

NTT DATA is seeking to hire a **Remote Claims Processing Associate** to work for our end client and their team.
**In this Role the candidate will be responsible for:**
+ Processing of Professional claim forms files by provider
+ Reviewing the policies and benefits
+ Comply with company regulations regarding HIPAA, confidentiality, and PHI
+ Abide with the timelines to complete compliance training of NTT Data/Client
+ Work independently to research, review and act on the claims
+ Prioritize work and adjudicate claims as per turnaround time/SLAs
+ Ensure claims are adjudicated as per clients defined workflows, guidelines
+ Sustaining and meeting the client productivity/quality targets to avoid penalties
+ Maintaining and sustaining quality scores above 98.5% PA and 99.75% FA.
+ Timely response and resolution of claims received via emails as priority work
+ Correctly calculate claims payable amount using applicable methodology/ fee schedule
**Requirements:**
+ 1-3 year(s) hands-on experience in Healthcare Claims Processing
+ 2+ year(s) using a computer with Windows applications using a keyboard, navigating multiple screens and computer systems, and learning new software tools
+ High school diploma or GED.
+ Previously performing - in P&Q work environment; work from queue; remotely
+ Key board skills and computer familiarity -
+ Toggling back and forth between screens/can you navigate multiple systems.
+ Working knowledge of MS office products - Outlook, MS Word and MS-Excel.
+ Must be able to work 7am - 4 pm CST online/remote (training is required on-camera).
**Preferred Skills & Experiences:**
+ Amisys Preferred
+ Ability to communicate (oral/written) effectively in a professional office setting
+ Effective troubleshooting where you can leverage your research, analysis and problem-solving abilities
+ Time management with the ability to cope in a complex, changing environment
**About NTT DATA**
NTT DATA is a $30+ billion trusted global innovator of business and technology services. We serve 75% of the Fortune Global 100 and are committed to helping clients innovate, optimize, and transform for long-term success. We invest over $.6 billion each year in R&D to help organizations and society move confidently and sustainably into the digital future. As a Global Top Employer, we have diverse experts in more than 50 countries and a robust partner ecosystem of established and start-up companies. Our services include business and technology consulting, data and artificial intelligence, industry solutions, as well as the development, implementation and management of applications, infrastructure, and connectivity. We are also one of the leading providers of digital and AI infrastructure in the world. NTT DATA is part of NTT Group and headquartered in Tokyo. Visit us at us.nttdata.com ( .
NTT DATA is an equal opportunity employer and considers all applicants without regarding to race, color, religion, citizenship, national origin, ancestry, age, sex, sexual orientation, gender identity, genetic information, physical or mental disability, veteran or marital status, or any other characteristic protected by law. We are committed to creating a diverse and inclusive environment for all employees. If you need assistance or an accommodation due to a disability, please inform your recruiter so that we may connect you with the appropriate team.
Where required by law, NTT DATA provides a reasonable range of compensation for specific roles. The pay rate for this remote role is 18 Hourly **.** This range reflects the minimum and maximum target compensation for the position across all US locations. Actual compensation will depend on several factors, including the candidate's actual work location, relevant experience, technical skills, and other qualifications.

**Patient Support Medical Claims Processing ? Representative**
_Contract Remote Role - Location (Open to Remote US)_
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 **Patient Support Medical Claims Processing Representative** to join our team. In this position, you will provide payment assistance solutions such as co-pay cards or vouchers. The **Patient Support Call Center Representative** 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 (shifts available: 9:00 am - 6:00 pm EST or, 10:00 am - 7:00 pm ET or, 11:00 am EST - 8:00pm EST) under moderate supervision
**Minimum Education & Experience:**
+ High School Diploma or equivalent
+ Experience in claim processing required
+ Medical Billing Certification required
+ Coding Certification required
+ Ability to interpret Explanation of Benefits (EOB)
+ HIPPA certified
+ Customer Service Experience preferred
+ Pharmacy Technician experience preferred
+ Bi-lingual (English/Spanish) preferred
**The pay range for this role is $23.00 per hour. To be eligible for this position, you must reside in the same country where the job is located.**
**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.
#LI-CES
#LI-DNP
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 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. potential base pay range for this role is $23.00 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.
IQVIA is a leading global provider of clinical research services, commercial insights and healthcare intelligence to the life sciences and healthcare industries. We create connections that accelerate the development and commercialization of innovative medical treatments. Everything we do is part of a journey to improve patient outcomes and population health worldwide.
To get there, we seek out diverse talent with curious minds and a relentless commitment to innovation and impact. No matter your role, everyone at IQVIA contributes to our shared goal of helping customers improve the lives of patients everywhere. Thank you for your interest in growing your career with us.
EEO Minorities/Females/Protected Veterans/Disabled

**Patient Support Medical Claims Processing ? Representative**
_Contract Remote Role - Location (Open to Remote US)_
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 **Patient Support Medical Claims Processing Representative** to join our team. In this position, you will provide payment assistance solutions such as co-pay cards or vouchers. The **Patient Support Call Center Representative** 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 (shifts available: 9:00 am - 6:00 pm EST or, 10:00 am - 7:00 pm ET or, 11:00 am EST - 8:00pm EST) under moderate supervision
**Minimum Education & Experience:**
+ High School Diploma or equivalent
+ Experience in claim processing required
+ Medical Billing Certification required
+ Coding Certification required
+ Ability to interpret Explanation of Benefits (EOB)
+ HIPPA certified
+ Customer Service Experience preferred
+ Pharmacy Technician experience preferred
+ Bi-lingual (English/Spanish) preferred
**The pay range for this role is $23.00 per hour. To be eligible for this position, you must reside in the same country where the job is located.**
**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.
#LI-CES
#LI-DNP
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 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. potential base pay range for this role is $23.00 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.
IQVIA is a leading global provider of clinical research services, commercial insights and healthcare intelligence to the life sciences and healthcare industries. We create connections that accelerate the development and commercialization of innovative medical treatments. Everything we do is part of a journey to improve patient outcomes and population health worldwide.
To get there, we seek out diverse talent with curious minds and a relentless commitment to innovation and impact. No matter your role, everyone at IQVIA contributes to our shared goal of helping customers improve the lives of patients everywhere. Thank you for your interest in growing your career with us.
EEO Minorities/Females/Protected Veterans/Disabled

**Patient Support Medical Claims Processing ? Representative**
_Contract Remote Role - Location (Open to Remote US)_
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 **Patient Support Medical Claims Processing Representative** to join our team. In this position, you will provide payment assistance solutions such as co-pay cards or vouchers. The **Patient Support Call Center Representative** 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 (shifts available: 9:00 am - 6:00 pm EST or, 10:00 am - 7:00 pm ET or, 11:00 am EST - 8:00pm EST) under moderate supervision
**Minimum Education & Experience:**
+ High School Diploma or equivalent
+ Experience in claim processing required
+ Medical Billing Certification required
+ Coding Certification required
+ Ability to interpret Explanation of Benefits (EOB)
+ HIPPA certified
+ Customer Service Experience preferred
+ Pharmacy Technician experience preferred
+ Bi-lingual (English/Spanish) preferred
**The pay range for this role is $23.00 per hour. To be eligible for this position, you must reside in the same country where the job is located.**
**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.
#LI-CES
#LI-DNP
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 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. potential base pay range for this role is $23.00 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.
IQVIA is a leading global provider of clinical research services, commercial insights and healthcare intelligence to the life sciences and healthcare industries. We create connections that accelerate the development and commercialization of innovative medical treatments. Everything we do is part of a journey to improve patient outcomes and population health worldwide.
To get there, we seek out diverse talent with curious minds and a relentless commitment to innovation and impact. No matter your role, everyone at IQVIA contributes to our shared goal of helping customers improve the lives of patients everywhere. Thank you for your interest in growing your career with us.
EEO Minorities/Females/Protected Veterans/Disabled

**Patient Support Medical Claims Processing ? Representative**
_Contract Remote Role - Location (Open to Remote US)_
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 **Patient Support Medical Claims Processing Representative** to join our team. In this position, you will provide payment assistance solutions such as co-pay cards or vouchers. The **Patient Support Call Center Representative** 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 (shifts available: 9:00 am - 6:00 pm EST or, 10:00 am - 7:00 pm ET or, 11:00 am EST - 8:00pm EST) under moderate supervision
**Minimum Education & Experience:**
+ High School Diploma or equivalent
+ Experience in claim processing required
+ Medical Billing Certification required
+ Coding Certification required
+ Ability to interpret Explanation of Benefits (EOB)
+ HIPPA certified
+ Customer Service Experience preferred
+ Pharmacy Technician experience preferred
+ Bi-lingual (English/Spanish) preferred
**The pay range for this role is $23.00 per hour. To be eligible for this position, you must reside in the same country where the job is located.**
**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 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. potential base pay range for this role is $23.00 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.
IQVIA is a leading global provider of clinical research services, commercial insights and healthcare intelligence to the life sciences and healthcare industries. We create connections that accelerate the development and commercialization of innovative medical treatments. Everything we do is part of a journey to improve patient outcomes and population health worldwide.
To get there, we seek out diverse talent with curious minds and a relentless commitment to innovation and impact. No matter your role, everyone at IQVIA contributes to our shared goal of helping customers improve the lives of patients everywhere. Thank you for your interest in growing your career with us.
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