Claims Audit Coordinator

Job Title: Claims Audit Coordinator Location: Houston, TX (Hybrid - 3 days in-office, remainder remote) Duration: 6 Months Pay Rate: $23-$25.81 on W2 per hour. Job Summary As a Claims Audit Coordinator / Collections Representative - Value-Based Care (VBC), you will play a pivotal role in managing and resolving complex accounts receivable (A/R). You will reconcile, research, and manage assigned accounts while handling claims inquiries and ensuring compliance with collection policies. This role involves close collaboration with internal teams, outside agencies, vendors, and clients to maintain A/R performance, meet aging targets, and drive timely payments. This position offers a great opportunity to develop technical expertise, contribute to process improvements, and grow professionally in a supportive, collaborative environment. Key Responsibilities Accurately execute Value-Based Reimbursement processes according to best practices and company policies. Analyze, research, and resolve assigned claims promptly. Communicate effectively with carriers, physician offices, patients, and management to ensure smooth claims resolution. Verify and update insurance benefits and eligibility. Process adjustments, post payments, and appeal claims when necessary. Obtain medical records and supporting documentation to secure timely claims payment. Maintain thorough and accurate documentation of all claims activity. Identify trends in claim denials or delays and recommend process improvements. Required Experience & Qualifications Minimum 2 years of experience in medical collections or value-based care accounts with a proven track record of accuracy and problem-solving. Strong analytical skills to review and interpret patient accounts and Explanation of Benefits (EOBs). Solid understanding of managed care, contract terms, and medical terminology. Experience in precertification, referrals, and insurance verification. Familiarity with ICD-9 and ICD-10 coding. Proficient in Microsoft Word, Excel, Outlook, Teams, and any EHR system. Exceptional verbal and written communication skills. Highly organized, self-motivated, and capable of multitasking under tight deadlines. Ability to work effectively with internal teams and external clients in a collaborative environment. Detail-oriented with strong critical thinking and problem-solving abilities. Flexibility to work occasional overtime during new client onboarding or special projects. Preferred Qualifications Associate's or Bachelor's degree. Experience in specialty care collections, particularly cardiology. Certified Professional Coder (CPC) credential. Work Environment Hybrid model: remote work with 3 days per week in-office in Houston, Texas. Fast-paced, collaborative, and results-driven team environment. Opportunities for professional development and process improvement initiatives.

Created: 2026-03-05