Job Description
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.
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