Role Description
As a Patient Support Medical Claims Processing Representative, you will provide payment assistance solutions such as co-pay cards or vouchers. The role involves:
• Receiving medical claims from HCPs or patients.
• Ensuring adequate supporting documentation has been provided.
• Interpreting the EOB/CMS1500.
• Vetting the claim against program specific business rules.
• Determining if the claim should be paid or rejected.
• Providing support for customer requests via telephone, email, fax, or other means of contact.
• Recognizing operational challenges and suggesting recommendations to management.
• Working 40 hours per week (shift available: 10:00am - 7:00pm ET) under moderate supervision.
Qualifications
• High School Diploma or equivalent.
• Experience in claim processing required.
• Medical Billing Certification required.
• Coding Certification required.
• Ability to interpret Explanation of Benefits (EOB).
• HIPAA certified.
• Customer Service Experience preferred.
• Pharmacy Technician experience preferred.
• Bi-lingual (English/Spanish) preferred.
Requirements
• Must reside in the same country where the job is located.
Benefits
• The potential base pay range for this role is $23.00 per hour.
• Actual base pay offered may vary based on qualifications, location, and schedule.
• Incentive plans, bonuses, and/or other forms of compensation may be offered.
• Range of health and welfare benefits may be included.