# Claims Collections Representative, Value-Based Care (VBC)

**Company**: Cedar Gate Technologies, an IQVIA business
**Location**: Houston, Texas
**Work arrangement**: hybrid
**Experience**: senior
**Job type**: full-time
**Salary**: $37,400.00 - $93,600.00
**Category**: Healthcare
**Industry**: Healthcare

**Apply**: https://iqvia.wd1.myworkdayjobs.com/en-US/IQVIA/job/Houston-Texas-United-States-of-America/Claims-Audit-Coordinator--Collections_R1562516?utm_source=yubhub.co&utm_medium=jobs_feed&utm_campaign=apply
**Canonical**: https://yubhub.co/job/claims-collections-representative-value-based-care-ae8b7455-f4a/

## Description

The Claims Collections Representative, Value-Based Care (VBC), plays an important role in resolving complex accounts receivable and outstanding claims associated with value-based care and bundled payment arrangements.

This position researches and reconciles accounts, investigates unresolved claims, navigates payer requirements, and works to ensure appropriate and timely reimbursement.

Responsibilities:

- Research and resolve complex claims and accounts receivable involving value-based care, bundled payments, and other healthcare reimbursement models.

- Analyze claims, payment variances, payer requirements, and contract terms to identify issues and drive resolution.

- Investigate account discrepancies and complete necessary corrections and adjustments.

- Work with payers, provider offices, clients, patients, and internal teams to resolve claims and reimbursement issues.

- Verify insurance, eligibility, and benefit information and ensure accurate payment posting.

- Prepare and submit appeals with appropriate medical records and supporting documentation.

- Identify reimbursement trends, recurring issues, and opportunities to improve claims resolution and collection processes.

- Support team initiatives, special projects, and other responsibilities as needed.

Requirements:

- Minimum of 3 years of experience in medical collections, revenue cycle, accounts receivable, or healthcare reimbursement.

- Experience researching and resolving claim denials, underpayments, payment discrepancies, and other complex reimbursement issues.

- Working knowledge of managed care contracts, payer policies, medical terminology, and healthcare reimbursement practices.

- Strong analytical and critical thinking skills with the ability to investigate account issues and interpret complex reimbursement and payment scenarios.

- Excellent verbal and written communication skills with the ability to clearly communicate complex claims and reimbursement information to payers, providers, clients, and internal teams.

- Ability to work independently, take initiative, solve problems, and exercise sound judgment with minimal supervision.

- Proficiency with Microsoft Excel, Outlook, and Word, including using Excel to review data and identify trends.

The potential base pay range for this role, when annualized, is $37,400.00 - $93,600.00.

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## Skills

### Required
- medical collections
- revenue cycle
- accounts receivable
- healthcare reimbursement
- managed care contracts
- payer policies
- medical terminology
- Microsoft Excel
- Outlook
- Word

### Nice to have
- cardiology experience
- value-based care or bundled payment arrangements experience

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Source: [Apply at iqvia.wd1.myworkdayjobs.com](https://iqvia.wd1.myworkdayjobs.com/en-US/IQVIA/job/Houston-Texas-United-States-of-America/Claims-Audit-Coordinator--Collections_R1562516?utm_source=yubhub.co&utm_medium=jobs_feed&utm_campaign=apply)