About The Role

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

Billing Coordinator is responsible for the timely and accurate preparation, review, and submission of medical claims to third-party payers. This position supports value-based care billing activities by ensuring claims are processed in accordance with established procedures, payer requirements, and contractual guidelines. The role requires maintaining accurate records, researching claim issues, and supporting daily billing operations.

Roles & Responsibilities

Prepare, review, and submit paper and electronic claims for processing and reimbursement.
Distribute claims to appropriate payers in accordance with established billing procedures.
Review claims for completeness and accuracy and correct invalid or incomplete claims as needed.
Maintain knowledge of billing and packaging protocols related to assigned service lines and reimbursement programs.
Research and document patient encounter information necessary for claim processing and reimbursement.
Monitor and report claim filing activity and billing exceptions according to department guidelines.
Identify, investigate, and resolve claim-related issues in coordination with internal and external stakeholders.
Maintain accurate physician, payer, and contract information within applicable systems.
Utilize designated billing and information systems to obtain patient, insurance, and claim information.
Support billing operations through data entry, claim auditing, claim filing, record maintenance, and cross-training activities.
Enter claim information into applicable systems and reconcile charges to ensure accuracy and completeness.
Review and route claims with missing or invalid information for research and resolution.
Maintain filing systems and records related to claims, provider transmittals, EOBs, medical records, and other supporting documentation.
Ensure compliance with HIPAA and company confidentiality requirements.
Participate in departmental meetings and required training activities.
Complete additional duties as assigned.