Reimbursement Specialist/Medical BillerAs the only global provider of commercial solutions, IQVIA understands what it takes to deliver nationally and internationally. Our teams help biopharma get their medicines 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 acting as the biopharma’s sales force to physicians or providing nurses to educate patients or prescribers. With the right experience, you can help deliver medical breakthroughs in the real world.Position Summary:AllCare Plus Pharmacy, an IQVIA company, is seeking a Reimbursement Specialist! Responsible for the daily evaluation and collaboration of identifying and addressing departmental needs and priorities. Is responsible for proper completion of all daily tasks in a timely fashion while ensuring compliance with all standard operating procedures, cross functionally. This is a remote position. This role will be a short-term contract role with IQVIA managed by an external agency, with the opportunity to be converted to an IQVIA full-time employee.Hours: Ability to work 40 hours per week.Shifts based on availability : 8:30 am EST – 5:00 pm EST or 9:00 am - 6:00 pm EST or 10:00 am - 7:00 pm EST or 11:00 am EST – 8:00pm EST under moderate supervisionSalary: $23/hrThe 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. AllCare Plus Pharmacy reserves the right to revise the job or to require that other or different tasks be performed as assigned.Primary Responsibilities:Work closely with the Program Sr. Director, Program Director, and the Program Managers to evaluate departmental needs and priorities Schedule and delegate projects amongst team members, as needed, to address departmental priorities Assist with projects or assignments as directed by Directors to support departmental priorities Track, assist in research, trend, and communicate issues identified among staff during projects Work collaboratively with cross functional teams to ensure all updates made by the Reimbursement Coordinator(s) and/or CM(s) that may impact other functional areas are communicated to all impacted persons/teams in a timely manner Work with call center leadership to identify improvements and provide plan of action proposals Consistently meet excellent quality requirements and follow all required interaction components as outlined in departmental SOP’s and protocols Maintain strong working knowledge of insurance carriers and third-party billing requirements Assist with the creation and review of SOPs Identify and quantify payor issues and proposed solutionsRequired Qualifications:
Associate’s Degree preferred
Minimum 3 years’ experience in pharmacy, healthcare, medical billing, insurance verification or similar experience
Minimum of 1 year working cross functionally among billing & reimbursement and/or HUB services departments
Exceptional communication and facilitation skills, both verbal and written, with a proven ability to communicate to all levels of the organization
Data entry skills and ability to type 30wpm Preferred Qualifications:
Experience verifying insurance eligibility and coverage including but not limited to: benefits, pre-certification and referrals, reimbursement Previous supervisory and training experienceProfessional Competencies:Business Skills and Knowledge
General Management
Demonstrate analytic and problem solving skills, and understand the impact of individual decisions on other parts of the organization and the environment.
Risk management
Knowledge of liability and compliance regulation, the ability to employ strategies to mitigate risk, avoid malpractice and plan for disasters.
Quality improvement
Application of techniques that continually improve the quality of care provided, patient safety, organizational performance, and the financial health of the organization.Knowledge of the Health Care Environment
Health Care Systems and Organizations
Demonstrate an understanding of how the various components of the health care system is organized and financed, and how they interact to deliver medical and health care.
The Patient’s Perspective
Understand the patient experience, demonstrate a commitment to patients’ rights and responsibilities, and ensure that the organization provides a safe environment for patients and their families.Communication and Relationship Management
Relationship Management
The ability to build and maintain relationships with internal as well as externalstakeholders that are anchored in trust and where decision-making is shared.
Communication Skills
Be able to utilize verbal, written and presentation skills to communicate anorganization’s mission, vision, values and priorities to diverse audiences.Leadership
The ability to inspire individual and organizational excellence, create and attain a shared vision and successfully manage change to attain the organization’s strategic ends and successful performance.
Professionalism
The ability to align personal and organizational conduct with ethical and professional standards that include a responsibility to the patient and community, a service orientation, and a commitment to lifelong learning and improvement.
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.comWe are committed to providing equal employment opportunities for all, including veterans and candidates with disabilities. https://jobs.iqvia.com/eoeIQVIA’s ability to operate and provide certain services to customers and partners necessitates IQVIA and its employees meet specific requirements regarding COVID-19 vaccination status. https://jobs.iqvia.com/covid-19-vaccine-statusThe 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.IQVIA is a world leader in using data, technology, advanced analytics, and expertise to help customers drive healthcare – and human health – forward. Together with the companies we serve, we are enabling a more modern, more effective and more efficient healthcare system, and creating breakthrough solutions that transform business and patient outcomes.To get there, it takes diverse skills and a curiosity to explore new possibilities. No matter your role, everyone at IQVIA, including our colleagues at Q Solutions, contributes to our shared goal of improving human health. Thank you for your interest in growing your career with us.EEO Minorities/Females/Protected Veterans/Disabled
