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 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.

Company Trajectory RCS joined the MedHQ family in 2024 after enjoying 10 years as a well-established revenue cycle company with an annual growth rate of 40% to 50% and 150 employees. Together they now serve small hospitals, physician groups, ambulatory surgery, and outpatient centers nationwide by optimizing. healthcare cash flow through integration of both business office processes and clinical documentation. MedHQ, LLC, is a fast growing, leading provider of consulting and technology enabled expert services for outpatient healthcare. With a 97% long-term, client retention rate spanning over 20 years, MedHQ serves Ambulatory Surgery Centers (ASCs), Surgical Hospitals, Physician Practices, and Hospital and Healthcare Outpatient Facilities nationwide. The MedHQ RITE Values: Respect, Innovation, Trust, and Energy, permeate all service line offerings with a unique personalized approach balancing exceptional transactional and emotional intelligence, and above all excellent customer service. MedHQ, LLC, is a 2022 Becker’s Top 150 Places to Work in Healthcare company. The MedHQ LLC service line offerings have grown organically over the years, beginning by providing high quality traditional human resource, accounting, and staff credentialing as a Professional Employer Organization, (PEO.) In 2022, MedHQ formed a relationship with 424 Capital, and quickly expanded into a well-rounded, menu services driven financial management company. This robust infusion of expert service line offerings has resulted in MedHQ and MedHQ clients’ efficiencies and growth. The MedHQ, LLC, menu of client services include Advisory, Client Human Resources, Client Accounting, Staff Credentialling, Clinical Staffing, and Revenue Cycle Services. For additional detailed information please review www.medhq.com and www.trajectoryrcs.com Position Overview We are seeking a meticulous and detail-oriented Medical Coder specializing in professional services, particularly ENT Surgery, Evaluation and Management (E&M) and tangential services. The ideal candidate will possess a strong understanding of coding guidelines, regulations, and reimbursement methodologies relevant to professional services in healthcare. Wound care knowledge would be beneficial to this position. Responsibilities - Accurately assign CPT, HCPCS, and ICD-10 codes for professional services, focusing on Evaluation and Management encounters and associated tangential services. - Review medical documentation to ensure coding compliance with regulatory and organizational guidelines. - Collaborate with healthcare providers and coding auditors to resolve coding discrepancies or documentation issues. - Maintain proficiency in current coding practices, regulations, and industry updates to ensure accurate and up-to-date coding. - Support internal teams by providing coding insights, education, and training on best practices related to professional services coding. - Identify and communicate potential compliance risks or areas for improvement in coding processes. Qualifications - Certified Professional Coder (CPC) credential or equivalent certification required (e.g., CCS-P, COC). - Proven experience in professional services coding, particularly in ENT Surgery and Evaluation and Management coding. - Strong knowledge of CPT, HCPCS, ICD-10 coding guidelines, and regulatory requirements related to professional services. - Proficiency in using coding software and electronic health record (EHR) systems. - Excellent analytical skills and attention to detail in reviewing medical documentation. - Ability to work independently and collaboratively in a fast-paced environment. - Effective communication skills to interact with healthcare providers, auditors, and internal teams. Benefits - Competitive compensation package - Health, dental, and vision insurance - Retirement savings plans - Generous paid time off - Opportunities for professional development - A collaborative and supportive work environment focused on growth and success This is a remote position. **Applicants must be legally authorized to work in the United States. We are unable to sponsor or take over sponsorship of an employment visa at this time.

City/State Richmond, VA Work Shift First (Days) Overview: Sentara Health is looking to hire a Remote Benefits Coding Analyst. This position is remote however, candidates must be able to commute to our Richmond location. The Benefits Coding Analyst – Certified Professional Coder maintains the integrity of the plan benefits for each program and is responsible for developing an extensive expertise of all plan benefits. The Benefits Coding Analyst will work closely with multiple teams across the Health Plan, including but not limited to Claims, Compliance, Program, IT, and Health Services/Medical Management to ensure benefits are compliant with state and Federal guidelines, as well as aligned with Program benefit offerings. This position is responsible for synthesizing the input from multiple stakeholders to inform significant business decisions regarding benefit implementation as well as coordinating and maintaining benefit design documentation for the organization. The Benefits Coding Analyst will research, code, and assist with the development of benefit and utilization review policies and criteria for emerging treatments, technology, medications, and health plan services. This role will assist in researching code updates, authorization requests, and claim questions, updating business rules and benefit repositories as appropriate. Education: - Associate Degree in Healthcare (preferred) Certification: • Certified Professional Coder certification (CPC) (required) • Certified Inpatient Coder (CIC) (preferred) • Medical Assistant Certification (preferred) Note: CIC is required for advancement to Level 2 and Level 3 Experience: • 2+ years of medical coding or billing experience specifically within reimbursement, coding, claims processing, claims auditing and /or various payment methodologies (required) • Experience in both established benefit coding environments as well as experience in determination of coding requirements for new benefits (preferred) • Experience resolving billing and claims issues related to benefit to code assignment. •Thorough knowledge of anatomy and medical terminology • Expertise with NCCI (National Correct Coding Initiative) guidelines • Knowledge or direct experience processing Government program or commercial health claims for an MCO • Experience with ICD-10 CM, CPT, HCPCS, QNXT. Keywords: Talroo-Allied Health, Healthcare, Coding, CPC, CIC, Billing, Claims, Auditing, ICD-10 CM, CPT, HCPCS, QNXT and Revenue coding in a managed care setting Benefits: Caring For Your Family and Your Career • Medical, Dental, Vision plans • Adoption, Fertility and Surrogacy Reimbursement up to $10,000 • Paid Time Off and Sick Leave • Paid Parental & Family Caregiver Leave • Emergency Backup Care • Long-Term, Short-Term Disability, and Critical Illness plans • Life Insurance • 401k/403B with Employer Match • Tuition Assistance – $5,250/year and discounted educational opportunities through Guild Education • Student Debt Pay Down – $10,000 • Reimbursement for certifications and free access to complete CEUs and professional development •Pet Insurance •Legal Resources Plan •Colleagues have the opportunity to earn an annual discretionary bonus if established system and employee eligibility criteria is met. Sentara Health is an equal opportunity employer and prides itself on the diversity and inclusiveness of its close to an almost 30,000-member workforce. Diversity, inclusion, and belonging is a guiding principle of the organization to ensure its workforce reflects the communities it serves. In support of our mission “to improve health every day,” this is a tobacco-free environment. For positions that are available as remote work, Sentara Health employs associates in the following states: Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington, West Virginia, Wisconsin, and Wyoming.

Role Description We are seeking a meticulous and detail-oriented Medical Coder specializing in professional services, particularly ENT Surgery, Evaluation and Management (E&M) and tangential services. The ideal candidate will possess a strong understanding of coding guidelines, regulations, and reimbursement methodologies relevant to professional services in healthcare. Wound care knowledge would be beneficial to this position. Responsibilities - Accurately assign CPT, HCPCS, and ICD-10 codes for professional services, focusing on Evaluation and Management encounters and associated tangential services. - Review medical documentation to ensure coding compliance with regulatory and organizational guidelines. - Collaborate with healthcare providers and coding auditors to resolve coding discrepancies or documentation issues. - Maintain proficiency in current coding practices, regulations, and industry updates to ensure accurate and up-to-date coding. - Support internal teams by providing coding insights, education, and training on best practices related to professional services coding. - Identify and communicate potential compliance risks or areas for improvement in coding processes. Qualifications - Certified Professional Coder (CPC) credential or equivalent certification required (e.g., CCS-P, COC). - Proven experience in professional services coding, particularly in ENT Surgery and Evaluation and Management coding. - Strong knowledge of CPT, HCPCS, ICD-10 coding guidelines, and regulatory requirements related to professional services. - Proficiency in using coding software and electronic health record (EHR) systems. - Excellent analytical skills and attention to detail in reviewing medical documentation. - Ability to work independently and collaboratively in a fast-paced environment. - Effective communication skills to interact with healthcare providers, auditors, and internal teams. Benefits - Competitive compensation package - Health, dental, and vision insurance - Retirement savings plans - Generous paid time off - Opportunities for professional development - A collaborative and supportive work environment focused on growth and success - This is a remote position.