Job Description

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.

The Revenue Coordinator, Transplant Collections is responsible for resolving complex accounts receivable (A/R) for Value-Based Care (VBC), primarily focusing on transplant accounts. This position is a member of a talented team of Collection Representatives who demonstrate superb technical competency while elevating those around them. A Revenue Coordinator, Transplant Collections is responsible for reconciling, managing, and researching assigned accounts, which may not always involve transplants. This team also handles all unresolved claims inquiries and issues and are responsible for following the company's collection policies and procedures. Occasionally, team members work with outside agencies, vendors, and clients to maintain the company's acceptable AR days, AR aging, and payments.

Roles & Responsibilities

• Complete Value-Based Reimbursement processes timely and accurately according to industry best practices and Cedar Gate Technologies standards.
• Analyze and correctly resolve assigned claims promptly.
• Communicate with carriers, physicians' offices, patients, and management to resolve issues and claims status.
• Accurately verify insurance benefits related to claims.
• Ensure insurance benefits are updated.
• Process required adjustments according to department protocol.
• Ensures payments are posted accurately.
• Properly appeal claims as needed.
• Obtain medical records and other documents from appropriate resources as needed for claims payment.

Job Location

Houston, TX

Work Arrangement

Hybrid (3 days in Houston office - Galleria Area, 2 days remote)

Experience / Qualifications

• Minimum of two (2) years of experience in medical collections
• Two (2) years of experience in medical transplant billing, case rate review, or revenue cycle management for transplants. Preference to multiorgan case rate experience.
• Ability to analyze both patient accounts and payer Explanation of Benefit responses
• Working knowledge of managed care, contract terms, and medical terminology
• Possess a positive attitude and a willingness to learn
• Self-motivated
• Excellent verbal and written communication skills
• Ability to work with both internal and external customers in a team atmosphere
• Demonstrated proficiency with Microsoft Word, Outlook, and Excel
• Excellent organizational skills and the ability to multitask
• Ability to work well under pressure and can prioritize and meet deadlines
• Associate's or Bachelor’s degree highly preferred
• A background in case management, special account billing, and multi-specialty environments is preferred

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 is 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.