Job Details

Description:
As a Collections Representative – Value-Based Care (VBC), you’ll play a pivotal role in managing and resolving complex accounts receivable (A/R) within our growing organization. Your focus will be on reconciling, researching, and managing assigned accounts while proactively handling claims inquiries and ensuring strict adherence to company collection policies and procedures. In this position, you’ll work closely with internal teams as well as outside agencies, vendors, and clients to maintain strong A/R performance, meet aging targets, and drive timely payments. This role offers an excellent opportunity to develop your technical expertise, contribute to process improvements, and be part of a talented and supportive team that values accuracy, collaboration, and professional growth.

Roles & Responsibilities

• Complete Value-Based Reimbursement processes accurately and on time, following industry best practices and IQVIA policies.
• Analyze and resolve assigned claims promptly.
• Communicate with carriers, physician offices, patients, and management to ensure smooth claims resolution.
• Verify and update insurance benefits.
• Process adjustments and post payments accurately.
• Appeal claims when needed.
• Obtain medical records and supporting documents to help secure timely and complete claims payment.

Job Location

• Hybrid Remote: Enjoy the flexibility of working from home and collaborating three days a week at our office in Houston, Texas

Required Experience / Qualifications

• Minimum of 5 years in medical collections or value-based care accounts, demonstrating a track record of accuracy, problem-solving, and timely resolution.
• Strong analytical ability to review and interpret both patient accounts and payer Explanation of Benefit (EOB) responses, identifying issues and resolving them efficiently.
• Solid understanding of managed care, contract terms, and medical terminology, with the ability to apply this knowledge to complex claims and reimbursement processes.
• Open-minded, eager to learn, adapt, and take on new challenges while contributing to a collaborative team environment.
• Self-motivated and able to take ownership of tasks, prioritize effectively, and drive results.
• Exceptional verbal and written communication skills
• Ability to work with both internal and external customers in a supportive team atmosphere
• Demonstrated proficiency with MS Word, Outlook, and Excel, as well as any EHR.
• Highly organized with the ability to multitask, manage competing priorities, and meet tight deadlines consistently.
• Thrive under pressure in a fast-paced environment while maintaining accuracy, professionalism, and a focus on results.

Preferences – Not Required

• Associate or Bachelor’s degree
• Specialty Care collections experience, especially cardiologic care
• Currently has Certified Professional Coder (CPC) certification

Pay Rate Range: $20-25/hr depending on experience