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 https://jobs.iqvia.com IQVIA 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. https://jobs.iqvia.com/eoe IQVIA is committed to integrity in our hiring process and maintains a zero tolerance policy for candidate fraud. All information and credentials submitted in your application must be truthful and complete. Any false statements, misrepresentations, or material omissions during the recruitment process will result in immediate disqualification of your application, or termination of employment if discovered later, in accordance with applicable law. We appreciate your honesty and professionalism. The 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.

Department: 10136 Enterprise Corporate - Clinical Data Registry Status: Full time Benefits Eligible: Yes Hours Per Week: 40 Schedule Details/Additional Information: Full Time - Remote Due to complex requirements, remote work is NOT permitted in: CA, DC, CO, CT, HI, MA, MD, MN, ND, NJ, NY, OR, RI, VT, WA and working Internationally.* Pay Range $26.55 - $39.85 Major Responsibilities: - Performs review of complex clinical records to secure data for inclusion into the formal longitudinal registries required by the organization. - Uses appropriate classification and coding systems via computerized software, within the time frames required by local, state and national mandates. - Abstracts high integrity information from the internal medical record and conducts concurrent and or retrospective review of external medical records in order to facilitate complete analysis, monitoring and reporting of quality data. - Performs interoperability and reliability testing and utilizes various data quality monitoring techniques to reconcile and validate information according to registry and internal data quality standards and data dictionaries. - Completes the process for timely submission of data at appropriate intervals to the various advanced and complex disease/procedure specific specialty databases and other registries as required for compliance with membership and professional standards. Coordinates multi-disciplinary weekly case conferences, preparing notices, summations and submits all required Continuing Professional Development department post-conference documentation for CME. - Develops, performs, and evaluates quality improvement activities for the registries ensuring a percent of abstracted data is physician and peer reviewed on an annual basis. - Performs follow-up of appropriate registry patients over their lifetime as required, maintaining the accuracy and integrity of the data for use in end-results, financial, market, research and quality reporting. - Establishes and maintains effective working relationships with physicians and care management staff working together to compile registry data into meaningful reports/displays and promotes the use and visibility of the information collected. - Prepares and assists with studies for publication, audits, and annual reports in a timely fashion. - Prepares and assists in developing and updating Registry "Policies and Procedures" on a yearly basis and complies with accrediting agency requirements. Licensure, Registration, and/or Certification Required: - None Required. Education Required: - Associate degree in health information management or related field (or if working in Cancer Registry, enrollment in Associate degree program and ready to start practicum). Experience Required: - Typically requires 1 year of experience in data collection that includes experiences in coding/abstracting and clinical documentation. Knowledge, Skills & Abilities Required: - Knowledge of medical terminology, anatomy and physiology and pathophysiology. - Knowledge of computer applications, computer function and basic statistical methods. - Ability to follow detailed coding instructions and specifications with minimal supervision. - Ability to work independently with a high degree of accuracy and attention to detail. - Ability to communicate well orally and in written format. - Ability to travel as needed with exposure to road and weather conditions. - Ability to spend extended periods of time (75% of the workday) in sedentary work. - Ability to operates all equipment necessary to perform the job. - Ability to secure required credentials according to internal and external requirements for abstraction. - Exposed to a normal office environment. Physical Requirements and Working Conditions: - Exposed to a normal office environment. - Exposure to road and weather conditions. - Ability to spend extended periods of time (75% of the workday) in sedentary work. - Operates all equipment necessary to perform the job. This job description indicates the general nature and level of work expected of the incumbent. It is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities required of the incumbent. Incumbent may be required to perform other related duties. Our Commitment to You: Advocate Health offers a comprehensive suite of Total Rewards: benefits and well-being programs, competitive compensation, generous retirement offerings, programs that invest in your career development and so much more – so you can live fully at and away from work, including: Compensation - Base compensation listed within the listed pay range based on factors such as qualifications, skills, relevant experience, and/or training - Premium pay such as shift, on call, and more based on a teammate's job - Incentive pay for select positions - Opportunity for annual increases based on performance Benefits and more - Paid Time Off programs - Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability - Flexible Spending Accounts for eligible health care and dependent care expenses - Family benefits such as adoption assistance and paid parental leave - Defined contribution retirement plans with employer match and other financial wellness programs - Educational Assistance Program About Advocate Health Advocate Health is the third-largest nonprofit, integrated health system in the United States, created from the combination of Advocate Aurora Health and Atrium Health. Providing care under the names Advocate Health Care in Illinois; Atrium Health in the Carolinas, Georgia and Alabama; and Aurora Health Care in Wisconsin, Advocate Health is a national leader in clinical innovation, health outcomes, consumer experience and value-based care. Headquartered in Charlotte, North Carolina, Advocate Health services nearly 6 million patients and is engaged in hundreds of clinical trials and research studies, with Wake Forest University School of Medicine serving as the academic core of the enterprise. It is nationally recognized for its expertise in cardiology, neurosciences, oncology, pediatrics and rehabilitation, as well as organ transplants, burn treatments and specialized musculoskeletal programs. Advocate Health employs 155,000 teammates across 69 hospitals and over 1,000 care locations, and offers one of the nation’s largest graduate medical education programs with over 2,000 residents and fellows across more than 200 programs. Committed to providing equitable care for all, Advocate Health provides more than $6 billion in annual community benefits.

Community Health Center of Snohomish County offers competitive wages and a comprehensive benefits package designed to address health, time off, retirement and career-advancement needs. Benefits available include health insurance (medical/dental/vision), up to 120 hours of vacation time pro-rated by FTE every 12 months, paid sick leave, 10-paid holidays, 403(b) Safe Harbor retirement plan with employer match, disability and life insurance, and more! We also offer $0.75/hour for those who test proficiently in a second language. *This position is eligible for remote work following completion of required onsite training. Candidates must reside in Washington State to participate in training and attend occasional in-person meetings as needed. Job Summary The Patient Access Specialist-Medical acts as the first point of contact with Community Health Center. The Specialist answers telephones in a centralized call center environment and performs a variety of clerical, reception and administrative tasks: transcribes messages, schedules appointments, pre-registers patients, and verifies insurance coverage. The Specialist may also document compliments, complaints and update patient demographics as needed. Knowledge, Skills & Abilities - Reads, speaks, understands and writes proficiently in English. - Knowledge of medical terminology. - Works independently and is self-directed. - Works effectively in a team environment. - Problem-solves with creativity and ingenuity. - Organizes, prioritizes, and coordinates multiple activities and tasks. - Works with initiative, energy and effectiveness in a fast-paced environment. - Produces work in high quantity and quality. - Remains calm and effective in high pressure and emergency situations. - Use of multi-line telephones and other office machines. - Proficiency in the use of Microsoft Office applications; Word, Excel and Outlook. Preferred: - Bilingual skills. - Knowledge of dental terminology. Education - High school graduate or equivalent. Preferred: - Graduate of an accredited Office Skills Certification Program or related field. - Graduate of an accredited Medical Administrative Assistant Certification program or related field. Experience - Customer service related experience working with the general public or a combination of equivalent education and work experience (1 year). Preferred: - Clerical reception, medical assisting, administrative or secretarial experience in a medical/dental setting or healthcare insurance organization (1 year). - Call Center experience (1 year). - Working with insurance/billing in a healthcare setting/insurance organization. - Experience in a multiple provider medical practice. - Digital imaging familiarity. - Healthcare information systems, such as electronic health record and practice management systems experience. - Working with low income, multi-ethnic populations. Job Specific Functions/Performance: - Pre-registers patients in a computerized practice management system. - Schedules patients in a computerized practice management system. Maintains appointment schedule and follows office scheduling policies. - Helps contact and reschedule patients when providers’ schedules change. - Directs phone calls to proper destination or takes messages within the electronic health record. - Assists with insurance eligibility verification and advises non-insured patients of insurance enrollment and sliding fee discount. - Answers or appropriately refers billing questions. - Assists in confirming appointments. - Orders interpreter services and interfaces with other outside organizations regarding patient services. - Documents compliments and complaints. - Accurately documents and routes task communications within the electronic health record. - Logs into and out of the telephone system daily as scheduled. - Meets the established Call Center daily and monthly goals for call standards (statistics). - Meets the customer service call quality standards. - Updates patient demographics as needed. - Adheres to attendance standards in order to perform the job functions for daily operations and/or continuity of patient care. CHC is an Equal Employment Opportunity/Affirmative Action Employer (EEO/AA)/At-will employer.

Company Description At Northwestern Medicine, every patient interaction makes a difference in cultivating a positive workplace. This patient-first approach is what sets us apart as a leader in the healthcare industry. As an integral part of our team, you'll have the opportunity to join our quest for better health care, no matter where you work within the Northwestern Medicine system. We pride ourselves on providing competitive benefits: from tuition reimbursement and loan forgiveness to 401(k) matching and lifecycle benefits, our goal is to take care of our employees. Ready to join our quest for better? Job Description The Coding Specialist II reflects the mission, vision, and values of NM, adheres to the organization's Code of Ethics and Corporate Compliance Program, and complies with all relevant policies, procedures, guidelines and all other regulatory and accreditation standards. The PB Coding Specialist II performs Current Procedural Terminology (CPT) and International Classification of Diseases, volume 10 (ICD10) coding through abstraction of the medical record with a focus on more complex encounters and/or has expertise with HCPCs procedural codes. This position has deep understanding of disease process, A&P and pharmacology and acts as a key collaborator with Providers and Clinical areas to ensure the medical record accurately reflects the patient's service. This position trains physicians and other staff regarding documentation, billing and coding, and performs various administrative and clerical duties to support the roles core function. The Coding Specialist II also demonstrates expertise to resolve Optum coding edits. Responsibilities: - Utilizes technical coding expertise to reviews the medical record thoroughly, utilizing all available documentation abstract and code physician professional services and diagnosis codes (including anesthesia encounters, operative room and surgical procedural services, invasive procedures and/or drug infusion encounters). Additionally, may include coding for Evaluation and Management services, bedside procedures and diagnostic tests as needed. - Follows Official Guidelines and rules in order to assign appropriate CPT, ICD10 codes and modifiers with a minimum of 95% accuracy. - Ensures charges are captured by performing various reconciliations (procedure schedules, OR logs and clinical system reports) - Provides documentation feedback to physicians - Maintains coding reference information - Trains physicians and other staff regarding documentation, billing and coding. - Reviews and communicates new or revised billing and coding guidelines and information - Attends meetings and educational roundtables, communicates pertinent information to physicians and staff. - Resolves pre-accounts receivable edits. Identifies repetitive documentation problems as well as system issues. - Makes appropriate changes to incorrectly billed services, adds missing unbilled services, provides missing data as appropriate, corrects CPT and ICD9 codes and modifiers. Adds MBO tracking codes as needed. - Collaborate with Patient Accounting, PB Billing, and other operational areas to provide coding reimbursement expertise; helps identify and resolve incorrect claim issues and is responsible for drafting letters in order to coordinate appeals - Acts as key point person for Revenue Cycle staff and Account Inquiry Unit staff in obtaining documentation (notes, operative reports, drug treatment plans, etc.). Provides additional code and modifier information to assist with appealing denials. May contact providers for peer-to-peer reviews. - Meets established minimum coding productivity and quality standards for each encounter type - May perform other duties as assigned. Qualifications Required: - Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT) or Certified Professional Coder (CPC) certification or Certified Coding Specialist (CCS). - Zero (0) to two (2) years of experience in a relevant role. - 94% accuracy on organizations coding test. Preferred: - Bachelor's or Associate's degree in a Health Information Management program accredited by the Commission on Accreditation for Health Informatics and Information Management Education (CAHIIM). - Previous experience with physician coding. Additional Information Northwestern Medicine is an equal opportunity employer (disability, VETS) and does not discriminate in hiring or employment on the basis of age, sex, race, color, religion, national origin, gender identity, veteran status, disability, sexual orientation or any other protected status. Background Check Northwestern Medicine conducts a background check that includes criminal history on newly hired team members and, at times, internal transfers. If you are offered a position with us, you will be required to complete an authorization and disclosure form that gives Northwestern Medicine permission to run the background check. Results are evaluated on a case-by-case basis, and we follow all local, state, and federal laws, including the Illinois Health Care Worker Background Check Act. Artificial Intelligence Disclosure Artificial Intelligence (AI) tools may be used in some portions of the candidate review process for this position, however, all employment decisions will be made by a person. Benefits We offer a wide range of benefits that provide employees with tools and resources to improve their physical, emotional, and financial well-being while providing protection for unexpected life events. Please visit our Benefits section to learn more. Sign-on Bonus Eligibility (if sign-on bonus offered for position): Internal employees and rehires who left Northwestern Medicine within 1 year are not eligible for the sign on bonus. Exception: New graduate internal employees seeking their first licensed clinical position at NM may be eligible depending upon the job family. - Job Shift: Day Job (1st) - Salary Range Minimum : $25.98 - Salary Range Maximum: $36.37 - Compensation: USD 25.98 - USD 36.37 - hourly