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Reimbursement Specialist/Medical Biller - Patient Support Call Center - Remote (Short-term Contract)

Durham, North Carolina, United States of America

Care Manager (Medical Billing/Insurance - Patient Support)

Position Summary:

Care Managers are responsible for contacting insurance companies to obtain correct eligibility information, perform benefit investigations, copay assistance and check prior authorization and/ or appeal status. This is a remote position. 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.

The information contained herein is intended to be an accurate reflection of the duties and responsibilities of the individuals assigned to this position. They are not intended to be an exhaustive list of the skills and abilities required to do the job. IQVIA reserves the right to revise the job or to require that other or different tasks be performed as assigned.

Primary Responsibilities:

  • Responsible for answering in-bound calls and assisting customers with pharmacy related services.
  • Obtain client information by answering telephone calls; interviewing clients; verifying information.
  • Contact insurance companies for benefit investigation and coverage eligibility.
  • Complete prior authorizations with attention to detail and accuracy, to then have the prepared prior authorization reviewed by a clinical pharmacist.
  • Assist patients with the enrollment process for manufacturer and non-profit organization copay assistance programs.
  • Provide customers with courteous, friendly, fast, and efficient service.
  • Update job knowledge by participating in educational opportunities and training activities.
  • Work efficiently both individually and within a team to accomplish required tasks.
  • Maintain and improve quality results by adhering to standards and guidelines and recommending improved procedures.
  • Any additional duties as assigned by program management.

Qualifications: Care Manager I

  • High School diploma required, associate degree or higher preferred.
  • Minimum 2+ years’ experience in medical billing, insurance verification, or similar patient services experience preferred.
  • Demonstrated time management skills; planning and prioritization skills; ability to multi-task and maintain prioritization of key projects and deadlines.
  • Demonstrated effective presentation skills; ability to motivate others; excellent interpersonal (written and verbal) communication skills.
  • Demonstrated effectiveness to work cross-functionally within a team.
  • Demonstrated ability to work effectively in an independent environment.
  • Demonstrated ability to build relationships with customers and third parties.
  • Demonstrated ability to adapt to a fast-paced, changing work environment and responsibilities.
  • Fully competent in MS Office (Word, Excel, PowerPoint)
  • Excellent documentation accuracy
  • Drive and enthusiasm for supporting customers.
  • Excellent listening and problem-solving skills
  • Experience using a CRM and integrated telephony platform a plus.
  • Previous data entry experience and ability to type 30wpm+
  • Bilingual (Spanish) highly desirable
  • Ability to use …
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