Medical Claims Processing Jobs: An Overview of the Role
Do you love connecting with people? Are you organized, self-motivated, and detail-oriented? A purposeful role that combines customer service skills with administration tasks, medical claims processing jobs are integral to our healthcare system and instrumental in getting people the right treatment when needed.
Better still, claims processing jobs can often be conducted remotely, and with so many benefits of maintaining the work-life balance that goes hand-in-hand with remote jobs, it’s a hard one to turn away.
This multifaceted role can vary greatly from company to company. Here at IQVIA, we have a whole range of medical biller job vacancies—more on that later. Depending on which company you look at, the role may be referred to as:
- Claims processing
- Medical claims processing
- Medical claims handling
- Medical claims billing
- Patient support medical claims processing representative
These names tend to be used interchangeably.
Generally speaking, if you’re a critical thinker, a people person, and someone who values a flexible yet stable career, working as a medical claims processing representative could be an excellent career choice that helps you live the kind of lifestyle you want.
Let’s tease out some of the main tasks that a medical claims processor may carry out in their line of work:
Job Description: What is the role of a medical claim handler?
1. Customer services
“What is the first step in processing a claim?”, you might ask. More often than not, it begins with the medical claims handler.
The primary role of a claim handler is to liaise between the patient and their insurer. The claim handler owes a duty of care to the patient, ensuring that their needs are being met and that they’re receiving the treatment or drugs they need.
This may involve speaking over the phone with patients, referring their cases to other professionals, offering advice on payment options and plans, retrieving and storing patient data, and providing general information about the healthcare system.
When a patient needs medical assistance, it’s often a medical claims processor that they first encounter. While AI is gaining traction in the medical claims world, patients value humans who can offer exceptional customer service skills. For anyone asking, “How can I improve my claims processing?”, improving their customer service skills is the natural first step.
2. Liaising with insurers
Do you love connecting with people? Communication is a fundamental part of the claims management process—particularly when it comes to insurance companies. The representative’s tasks may include reviewing paperwork related to a patient’s claim, ensuring it is all in order, and contacting their insurers when queries arise about the claim.
3. Investigating cases
Sometimes, a medical claims processor will have to look into claims where payment was denied. Commonly due to issues of insurance coverage eligibility, the claims handler may be tasked with reviewing documentation from the patient, their physicians, or the insurance company. This is where your eagle-eyed attention to detail and critical thinking skills will have their moment to shine.
The claims processor may need to serve as the go-between and provide explanations to the patient about the limitations of their insurance plan on behalf of the insurer.
4. Data management
Is being discreet one of your strong points? As a medical claims biller handles large volumes of sensitive data on an everyday basis, strong organization skills and confidentiality are key. The role may call for the use of particular data management software, spreadsheets, and medical history databases—all whilst making sure patients’ information stays private.
5. Administration
The role goes beyond pure data management—although that’s a big part of it. Common tasks assigned to a medical claims biller may include reviewing patient records, updating old information, processing payments, filing documents, submitting patient data to insurance companies, and communicating with stakeholders across the healthcare industry.
Discover the world of medical claims processor jobs
While the role of a claims handler varies greatly between companies, the general scope of tasks associated with the job is much the same. Typically, the role spans customer relations, data management, administration, and liaising with insurance companies.
IQVIA is currently recruiting medical claims processors in a variety of locations (as well as some remote opportunities). Explore our medical biller jobs page and discover the professional opportunities available today.
Find out more about life at IQVIA
Did you know IQVIA has
70,000 + brave minds
from clinicians to data scientists each transforming healthcare in 100+ countries
Did you know IQVIA has
1,200 +
epidemiologists
and real world insight experts
Related jobs
Salary:
Location:
Austin
Job Type
Regular
Employment status
Part Time
Job Category
Nurse Advisors
Location
Austin
Description
Our RN Clinical Educators experience a unique opportunity to employ their clinical nursing expertise in a new way outside patient care, while continuing to collaborate with healthcare professionals an
Reference
R1447281
Expiry Date
01/01/0001
Author
Pedro GodomarAuthor
Pedro GodomarSalary:
Location:
Chicago
Job Type
Regular
Employment status
Full Time
Job Category
Medical Sales
Location
Chicago
Description
**This is a pipeline job posting to gather resumes for future roles**Join the IQVIA team, where diversity and inclusion thrive in a workplace committed to improving patients' lives. We recognize that
Reference
R1443097
Expiry Date
01/01/0001
Author
Larry ShoupAuthor
Larry ShoupSalary:
Location:
Albany, Hartford, White Plains, New Haven
Job Type
Regular
Employment status
Full Time
Job Category
Medical Sales
Location
Hartford
Albany
White Plains
New Haven
Description
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 t
Reference
R1449326
Expiry Date
01/01/0001
Author
Lesley FriesAuthor
Lesley FriesRelated posts
Teaser
Medical Sales & ServicesContent Type
ArticlePublished
10/09/2024
Summary
The pharmaceutical sales industry is highly competitive yet rewarding. It’s a career that offers professionals the chance to develop interpersonally and gain a stronger understanding of medicine, as
Teaser
GeneralContent Type
ArticlePublished
10/08/2024
Summary
Recently, we interviewed Corinne Scott, Client Services Manager at IQVIA for her insight into how to decide a career change. Corinne shared her own journey and valuable advice with us to help answer
by
Corinne Scott
Teaser
SalesContent Type
ArticlePublished
10/04/2024
Summary
Virtual Sales has a growing presence in the healthcare and medical solutions industry, especially since the pandemic. Virtual Sales is set to be the new normal, even as we’ve emerged on the other si
by
Lesley Fries
IQVIA has been behind my development to become a MSL. The contracts that I have worked on have allowed me to push clinical projects with a recent opportunity to manage a pilot scheme integrating e-detailing into an established field based team. The result was an increase in sales.
IQVIA has been behind my development to become a MSL. The contracts that I have worked on have allowed me to push clinical projects with a recent opportunity to manage a pilot scheme integrating e-detailing into an established field based team. The result was an increase in sales.
Recently Viewed jobs
Salary:
Location:
St. Louis
Job Type
Regular
Employment status
Full Time
Job Category
Medical Sales
Location
St. Louis
Description
Job Description:The Foot & Ankle (F&A) Sales Associate will be responsible for the growth and development of the F&A HCP customer base in an assigned geography. They must achieve a level of expertise
Reference
R1434540
Expiry Date
01/01/0001
Author
Lesley FriesAuthor
Lesley Fries