Manager, Claims Billing (VBC)
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
As the Billing Manager, Value-Based Care (VBC) Operations, you will lead the billing function for a portfolio of specialty care provider clients, ensuring strong financial performance, operational excellence, and exceptional client satisfaction. You will oversee a team of Billing Coordinators, drive revenue cycle performance, and play a critical role in optimizing billing and collections processes within a growing value-based care environment.
Roles & Responsibilities
Lead and oversee professional billing operations, including claim submission, payment posting, denial management, appeals, and accounts receivable follow-up.
Manage, coach, and develop billing staff through hiring, onboarding, training, performance management, and ongoing professional development.
Partner closely with the Collections Manager and collections team to optimize revenue cycle performance, reduce aging accounts receivable, and improve collection outcomes.
Monitor key revenue cycle metrics and identify opportunities to improve billing accuracy, reimbursement performance, and operational efficiency.
Analyze reimbursement trends, payer performance, denials, and accounts receivable data to drive informed business decisions.
Partner with coding, credentialing, operations, finance, and client service teams to improve charge capture, reduce claim rejections, and optimize reimbursement.
Ensure compliance with payer requirements, CMS regulations, contractual obligations, and company policies.
Support payer contract reimbursement reviews, underpayment identification, and payment variance analysis.
Develop and maintain billing policies, procedures, workflows, controls, and departmental performance standards.
Lead process improvement initiatives that enhance scalability, productivity, and revenue cycle outcomes.
Prepare and present reporting and recommendations to leadership regarding operational performance and financial results.
Support value-based care and bundled payment initiatives by monitoring billing performance, identifying reimbursement opportunities, and ensuring alignment with program and client objectives.
Experience / Qualifications
5+ years of experience in professional medical billing, revenue cycle management, or healthcare reimbursement, including at least 2 years of experience leading billing, collections, accounts receivable, or revenue cycle teams.
Strong understanding of Medicare, Medicaid, commercial, and managed care reimbursement methodologies, payer requirements, and revenue cycle best practices.
Experience analyzing billing data, reimbursement trends, KPIs, payer performance, and accounts receivable metrics to drive operational improvements and financial results.
Proficiency with practice management systems, revenue cycle platforms, electronic health records (EHRs), Microsoft Excel, and reporting tools.
Proven leadership, coaching, problem-solving, and organizational skills, with the ability to manage multiple priorities in a fast-paced healthcare environment.
Bachelor's degree in Healthcare Administration, Business Administration, Finance, Accounting, or a related field preferred; equivalent combination of education and experience will be considered.
Cardiovascular billing experience strongly preferred.
Experience in a physician practice, MSO, specialty medical group, ambulatory care setting, value-based care environment, or population health program is preferred.
Preference for those with professional certification such as CPC, CPB, CRCP, or equivalent.
Knowledge of CPT, ICD-10, and HCPCS coding concepts, payer contract reimbursement analysis, and underpayment identification is preferred.
Job Location
Houston, TX (Galleria Area)
Work Arrangement
Hybrid (3 days in office, 2 remote)