Medical Biller/Claims Processing - Patient Support Representative (Home-Based)

Location: 100% remote within the United States; the role is associated with New Providence, New Jersey

Salary: $23.00 per hour

Company

hirify.global provides clinical research services, commercial insights, and healthcare intelligence for the life sciences and healthcare industries.

What you will do

• Receive medical claims from healthcare providers and patients and verify that supporting documentation is complete.
• Interpret Explanation of Benefits (EOB) statements and CMS-1500 forms.
• Review claims against program-specific business rules and determine whether they should be approved or rejected.
• Provide customer support by phone, email, fax, and other communication channels.
• Identify operational challenges and recommend solutions to management.
• Manage a 40-hour weekly workload, prioritize tasks, and meet productivity and quota expectations.

Requirements

• High school diploma or equivalent.
• Completion of a medical billing program, a medical billing degree, or a certified medical billing license.
• Experience processing claims and interpreting EOBs.
• Experience with insurance verification and payment postings.
• Call center or customer service experience, including inbound and outbound calls.
• Ability to follow HIPAA guidelines and work remotely within the United States.

Nice to have

• Revenue cycle experience.
• Proficiency in Microsoft Office, including Excel, Word, Outlook, and Teams.
• Experience with secondary and tertiary billing.
• Familiarity with complex insurance scenarios and multi-layered billing processes.

Culture & Benefits

• Fully remote, work-from-home arrangement.
• Career development opportunities.
• Collaborative culture focused on client service, execution, teamwork, integrity, and results.
• Contract engagement managed by an external agency, with potential conversion to an hirify.global full-time employee.