Claims Audit Coordinator, Collections at IQVIA · Houston

Claims Audit Coordinator, Collections

Location: Houston, Texas, United States of America

About Cedar Gate Technologies

Cedar Gate Technologies, an IQVIA business, enables payers, providers, employers, and service administrators to excel at value-based care with a unified technology and services platform delivering analytics, care, and payment technology on a single data management foundation. At Cedar Gate, you’ll be part of a collaborative, innovative environment where great ideas thrive. We invest deeply in our people through ongoing training, comprehensive benefits, and a strong culture of teamwork, offering the chance to grow your skills while contributing to high impact initiatives for some of the world's most dynamic companies.

Position Summary

The Collections Representative is responsible for managing assigned accounts receivable (A/R) and supporting collection activities related to value-based care reimbursement programs. This role focuses on researching and resolving claims, maintaining accurate account documentation, and following established collection policies and procedures. The position works with internal departments, clients, vendors, and payers to address outstanding balances and support revenue cycle operations.

Roles & Responsibilities

• Complete value-based reimbursement activities in accordance with company policies and established procedures.
• Research, analyze, and resolve assigned claims and account issues.
• Communicate with carriers, physician offices, patients, and internal stakeholders regarding claim status and payment resolution.
• Verify insurance coverage and benefits information.
• Process payment postings and account adjustments.
• Submit claim appeals as appropriate.
• Obtain medical records and supporting documentation necessary for claim review and reimbursement.
• Maintain accurate account records and documentation.
• Meet productivity, quality, and aging objectives established by management.
• Perform other duties as assigned.

Job Location

Houston, TX (Galleria Area)

Work Arrangement

Hybrid (3 days in office, 2 remote)

Experience / Qualifications

• Minimum of 3 years of experience in medical collections, healthcare accounts receivable, or value-based care reimbursement.
• Ability to review patient accounts and Explanation of Benefits (EOBs) to identify and resolve payment issues.
• Working knowledge of managed care, reimbursement processes, medical terminology, and payer requirements.
• Strong organizational skills and attention to detail.
• Ability to manage multiple assignments and meet deadlines.
• Effective verbal and written communication skills.
• Proficiency with Microsoft Outlook, Word, Excel, and electronic health record (EHR) systems.
• Ability to work independently and as part of a team.
• Experience with value-based care reimbursement models.
• High School or GED diploma required; Associate's or Bachelor's degree is preferred
• Prefer those who have experience with specialty physician practice collections, particularly cardiovascular services.
• Certified Professional Coder (CPC) certification is preferred.
• To be eligible for this position, you must reside in the same country where the job is located.

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, when annualized, is $37,400.00 - $93,600.00. 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.