What Jobs are available for Claims Processing in the United States?

**Become a part of our caring community and help us put health first**
The Claims Processing Representative 2 adjudicates pharmacy claims and processes pharmacy claims for payment & performs varied activities and moderately complex administrative/operational/customer support assignments. Performs computations. Typically works on semi-routine assignments.
The Claims Processing Representative 2 determines whether to return, deny, or pay claims following organizational policies and procedures. Decisions are typically focused on interpretation of area/department policy and methods for completing assignments. The role will also involve outreach to member or pharmacy in conjunction with Claim Processing duties. Expectations are production based wherein associate success is gauged on efficiency, accuracy, and minimal idle time activity.
**Use your skills to make an impact**
**Required Qualifications**
+ High School Diploma or equivalent
+ 1-3 years of experience within the Healthcare and/or insurance industry
+ Role requires a repeating, rotating schedule of Monday-Friday and Tuesday-Saturday with weekday hours being 9:00 AM-5:30 PM EST and Saturday being 7:00 AM-3:30 PM EST.
+ Strong computer navigation and Data Entry skills
+ Must be passionate about contributing to an organization focused on continuously improving consumer experiences
**Preferred Qualifications**
+ Bilingual candidates strongly preferred
+ Medical or pharmacy benefit claim processing experience is ideal
+ Customer service telephone experience
+ Intermediate Microsoft application skills
+ Previous employment with work at home background
**Additional Information**
Interview Format:
As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.
Alert: Humana values personal identity protection. Please be aware that applicants selected for leader review may be asked to provide a social security number, if it is not already on file. When required, an email will be sent from with instructions to add the information into the application at Humana's secure website.
**Work at home requirements:**
To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria:
At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested.
Satellite, cellular and microwave connection can be used only if approved by leadership.
Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job.
Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.
**SSN Alert:**
Humana values personal identity protection. Please be aware that applicants may be asked to provide their Social Security Number, if it is not already on file. When required, an email will be sent from with instructions on how to add the information into your official application on Humana's secure website.
Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
**Scheduled Weekly Hours**
40
**Pay Range**
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.
$30,000 - $39,200 per year
**Description of Benefits**
Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
**About Us**
Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.

**Equal Opportunity Employer**
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our

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 **Senior Medical Claims Examiner** . If you are a team player with a passion for health care and attention to detail this is the opportunity for you.
**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 in the NY Capital District** , one of **the Best Companies to Work For in New York** , and an **Inclusive Workplace** .
**Qualifications you'll bring:**
+ AAS degree with claims experience preferred, or equivalent combination of education and experience will be considered.
+ The availability to work Full-Time, Virtual within New York State
+ Two years' experience processing health insurance claims 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.
+ Ability to prioritize multiple assignments with attention to details and deadlines in a high-volume environment.
+ 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:**
+ Provide feedback to the unit leader on daily activities and priority issues
+ Act as the point person for each unit and handle E-mail, internal and corporate service forms, and phone inquiries
+ Monitor and assist with the distribution of SF's and E-mail correspondence for claim corrections
+ Calculate daily production goals for each unit and review aged claim reports
+ Run reports showing the daily production numbers of each examiner and produce weekly and monthly unit production reports
+ Analyze claims processing trends and create reports from Facets system selects and downloads
+ Specialize train new and existing claims examiners and forward new claim procedures, processes, and information
+ Provide routine call coaching/question time to E-workers and review quality control appeals
+ Responsible for outbound calls/faxes to provider offices for our member submitted claims.
+ Reviews quality control on claims as well as appeals. Will work with Quality Assurance on any discrepancies on errors between the examiners and makes first line decisions regarding the outcome of appeals.
**Where you'll be:**
Virtual within New York State, preferably Schenectady, Rochester, or Tarrytown
**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 .
**Job Details**
**Job Family** **Claims/Operations**
**Pay Type** **Hourly**
**Hiring Min Rate** **23 USD**
**Hiring Max Rate** **27 USD**

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 **Senior Medical Claims Examiner** . If you are a team player with a passion for health care and attention to detail this is the opportunity for you.
**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 in the NY Capital District** , one of **the Best Companies to Work For in New York** , and an **Inclusive Workplace** .
**Qualifications you'll bring:**
+ AAS degree with claims experience preferred, or equivalent combination of education and experience will be considered.
+ The availability to work Full-Time, Virtual within New York State
+ Two years' experience processing health insurance claims 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.
+ Ability to prioritize multiple assignments with attention to details and deadlines in a high-volume environment.
+ 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:**
+ Provide feedback to the unit leader on daily activities and priority issues
+ Act as the point person for each unit and handle E-mail, internal and corporate service forms, and phone inquiries
+ Monitor and assist with the distribution of SF's and E-mail correspondence for claim corrections
+ Calculate daily production goals for each unit and review aged claim reports
+ Run reports showing the daily production numbers of each examiner and produce weekly and monthly unit production reports
+ Analyze claims processing trends and create reports from Facets system selects and downloads
+ Specialize train new and existing claims examiners and forward new claim procedures, processes, and information
+ Provide routine call coaching/question time to E-workers and review quality control appeals
+ Responsible for outbound calls/faxes to provider offices for our member submitted claims.
+ Reviews quality control on claims as well as appeals. Will work with Quality Assurance on any discrepancies on errors between the examiners and makes first line decisions regarding the outcome of appeals.
**Where you'll be:**
Virtual within New York State, preferably Schenectady, Rochester, or Tarrytown
**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 .
**Job Details**
**Job Family** **Claims/Operations**
**Pay Type** **Hourly**
**Hiring Min Rate** **23 USD**
**Hiring Max Rate** **27 USD**

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 **Senior Medical Claims Examiner** . If you are a team player with a passion for health care and attention to detail this is the opportunity for you.
**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 in the NY Capital District** , one of **the Best Companies to Work For in New York** , and an **Inclusive Workplace** .
**Qualifications you'll bring:**
+ AAS degree with claims experience preferred, or equivalent combination of education and experience will be considered.
+ The availability to work Full-Time, Virtual within New York State
+ Two years' experience processing health insurance claims 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.
+ Ability to prioritize multiple assignments with attention to details and deadlines in a high-volume environment.
+ 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:**
+ Provide feedback to the unit leader on daily activities and priority issues
+ Act as the point person for each unit and handle E-mail, internal and corporate service forms, and phone inquiries
+ Monitor and assist with the distribution of SF's and E-mail correspondence for claim corrections
+ Calculate daily production goals for each unit and review aged claim reports
+ Run reports showing the daily production numbers of each examiner and produce weekly and monthly unit production reports
+ Analyze claims processing trends and create reports from Facets system selects and downloads
+ Specialize train new and existing claims examiners and forward new claim procedures, processes, and information
+ Provide routine call coaching/question time to E-workers and review quality control appeals
+ Responsible for outbound calls/faxes to provider offices for our member submitted claims.
+ Reviews quality control on claims as well as appeals. Will work with Quality Assurance on any discrepancies on errors between the examiners and makes first line decisions regarding the outcome of appeals.
**Where you'll be:**
Virtual within New York State, preferably Schenectady, Rochester, or Tarrytown
**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 .
**Job Details**
**Job Family** **Claims/Operations**
**Pay Type** **Hourly**
**Hiring Min Rate** **23 USD**
**Hiring Max Rate** **27 USD**

Job Description

Job Description

Maven is the world's largest virtual clinic for women and families on a mission to make healthcare work for all of us. Maven's award-winning digital programs provide clinical, emotional, and financial support all in one platform, spanning fertility & family building, maternity & newborn care, parenting & pediatrics, and menopause & midlife. More than 2,000 employers and health plans trust Maven's end-to-end platform to improve clinical outcomes, reduce healthcare costs, and provide equity in benefits programs. Recognized for innovation and industry leadership, Maven has been named to the Time 100 Most Influential Companies, CNBC Disruptor 50, Fast Company Most Innovative Companies, and FORTUNE Best Places to Work. Founded in 2014 by CEO Kate Ryder, Maven has raised more than $425 million in funding from top healthcare and technology investors including General Catalyst, Sequoia, Dragoneer Investment Group, Oak HC/FT, StepStone Group, Icon Ventures, and Lux Capital. To learn more about Maven, visit us at mavenclinic.com.

An award-winning culture working towards an important mission – Maven Clinic is a recipient of over 30 workplace and innovation awards, including:

• Fortune Change the World (2024)
• CNBC Disruptor 50 List (2022, 2023, 2024)
• Fortune Best Workplaces for Millennials (2024)
• Fortune Best Workplaces in Health Care (2024)
• TIME 100 Most Influential Companies (2023)
• Fast Company Most Innovative Companies (2020, 2023)
• Built In Best Places to Work (2023)
• Fortune Best Workplaces NY (2020, 2021, 2022, 2023, 2024)
• Great Place to Work certified (2020, 2021, 2022, 2023, 2024)
• Fast Company Best Workplaces for Innovators (2022)
• Built In LGBTQIA+ Advocacy Award (2022)

Maven is seeking a Manager, Member Benefit Services with deep, hands-on experience in fertility benefits to lead a team of 10+ Member Services Representatives. This role is ideal for someone who has worked directly with fertility patients and has a thorough understanding of the complexities of insurance coverage, billing, and reimbursement in the fertility space.

This role goes beyond people management — we're seeking a true fertility benefits expert who can take ownership of complex financial and insurance escalations. You will serve as a key subject matter expert on fertility-related billing issues, out-of-network claims, insurance coordination, and member financial tracking, driving timely and equitable solutions for our members, employers, and payer partners.

You'll play a pivotal role in shaping team culture and building scalable processes that ensure we continue delivering high-quality, empathetic care to members on their family-building journeys. We're looking for someone who is ready to roll up their sleeves, solve problems alongside their team, and inspire high performance through compassionate leadership.

For this role, we are seeking someone with flexibility to work a variety of shifts during business hours, primarily Monday through Friday, within Eastern U.S. time.

As a Manager, Member Benefit Services at Maven, you will:

• Be the ultimate people manager. Conduct regular one-on-ones, performance reviews, and development planning to promote employee growth and high-impact performance across a team of Member Services Associates and Senior Associates.
• Act as the primary escalation point for member issues and complex fertility-related financial and billing issues, driving problems to resolution while managing communication with key stakeholders.
• Learn the ins and outs of Maven's business and the day-to-day Member Benefit Services team responsibilities, diving in to directly master our various communication channels and reimbursement processes.
• Lead by example to ensure a culture focused on empathetic care, ensuring that the needs of our members are met in an exceptional manner.
• Directly answer member inquiries on inbound/outbound calls and Zendesk messages in times of high volume or during staffing gaps.
• Use your continuous improvement mindset to define and iterate on processes, making positive enhancements to drive efficiency, value, and accountability toward KPIs.
• Ensure team performance metrics are met; including but not limited to: productivity, response time, NPS, and CSAT.
• Report on MBS team metrics, KPIs, OKRs, to the director of MBS as well as cross functionally.
• Facilitate the team's alignment with broader organizational objectives and effectively lead through change.
• Review, maintain, and create MBS team SOPs, workflows, and communications to the team to ensure understanding and alignment on MBS team processes.
• Collaborate cross-functionally with our Care Delivery/Advocacy, Support, Operations, Product, Data, Provider Operations, Payment, Engineering, and Client Success teams.
• Coordinate new hire training and take an active role in the success of new employees during onboarding and training.
• Perform other duties as assigned.

We're looking for you to bring:

• 5–7 years of experience in Customer Service Operations, including team leadership roles
• 3+ years of experience managing teams of 10+ in a service/support environment
• 2+ years of direct experience resolving complex fertility financial and benefits billing issues, including coordination with payers and employer-sponsored benefit plans.
• 1–3 years of experience in managed healthcare, insurance, or employer benefits.
• Strong track record of mentoring and coaching team member
• Flexibility and experience managing in fast-paced, high-growth environments.
• Experience managing inbound and outbound call support, email or app-based written support.
• Track record of driving improvement with impactful and measurable results.
• Demonstrated ability to analyze performance metrics to identify trends, root causes, and improvement opportunities; uses data-driven insights to proactively solve problems and drive operational excellence.
• A strong sense of empathy applied to direct reports, members, and cross functional business partners.
• Savvy business judgment and the ability to support data-driven, results-oriented decision-making.
• Experience in motivating a team to achieve KPIs, drive efficiency, and managing change.
• The ability to create order from chaos and a willingness to roll up your sleeves to solve challenging problems directly.

Additional helpful experience and skills:

• Experience working in a fast-paced startup environment.
• Experience in Zendesk is a plus.
• Prior experience managing payments.
• Bachelor's degree or equivalent experience.
• Verbal and written fluency in Spanish.
• Experience managing remote based employees and teams.

The base salary range for this role is $06,000 - 115,000 per year. You will also be entitled to receive stock options and benefits. Individual pay decisions are based on a number of factors, including qualifications for the role, experience level, and skillset.

This role requires active work authorization in the US.

Maven embraces a flexible and inclusive work environment. This role is fully remote and open to candidates located within the United States. Maven is committed to supporting remote team members with the tools and collaborative culture needed to thrive regardless of location. This policy reflects our belief that great work can happen anywhere and that flexibility enables our team to do their best work.

At Maven we believe that a diverse set of backgrounds and experiences enrich our teams and allow us to achieve above and beyond our goals. If you do not have experience in all of the areas detailed above, we hope that you will share your unique background with us in your application and how it can be additive to our teams.

Benefits That Work For You

Our benefits are designed to support your health, well-being and career development, helping you thrive both personally and professionally. We remain focused on providing a competitive benefits package for our employees. On top of standards such as employer-covered health, dental, and insurance plan options, we offer an inclusive approach to benefits:

• Maven for Mavens: access to the full platform and specialists, including care for mental health, reproductive health, family planning and pediatrics.
• Whole-self care through wellness partnerships
• Hybrid work, in office meals, and work together days
• 16 weeks 100% paid parental leave and new parent stipend (for Mavens who've been with us for 1 year+)
• Annual professional development stipend and access to a personal career coach through Maven for Mavens
• 401K matching for US-based employees, with immediate vesting

These benefits are applicable to Maven Clinic Co., US-based, full-time employees only. 1099/Contract Providers are ineligible for these benefits.

Maven is an affirmative action and equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, disability, age, sexual orientation, gender identity, national origin, veteran status, or genetic information. Maven is committed to providing access, equal opportunity and reasonable accommodation for individuals with disabilities in employment, its services, programs, and activities. Maven Clinic interview requests and job offers only originate from an @mavenclinic.com email address (e.g ). Maven Clinic will never ask for sensitive information to be delivered over email or phone. If you receive a scam issue or a security issue involving Maven Clinic please notify us at: For general and additional inquiries, please contact us at

**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: 8:00am - 5:00pm EST or, 9:00am - 6:00pm EST or, 10:00am - 7:00pm ET or, 11:00am - 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-REMOTE
#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: 8:00am - 5:00pm EST or, 9:00am - 6:00pm EST or, 10:00am - 7:00pm ET or, 11:00am - 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-REMOTE
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: 8:00am - 5:00pm EST or, 9:00am - 6:00pm EST or, 10:00am - 7:00pm ET or, 11:00am - 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-REMOTE
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: 8:00am - 5:00pm EST or, 9:00am - 6:00pm EST or, 10:00am - 7:00pm ET or, 11:00am - 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-REMOTE
#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