Accounts Receivable & Denials Specialist

Privia Health; United States; Remote; USD 33,000 - 36,000; Full time

Benefits offered by this job

Medical, dental, vision, life보험

401K

Paid time off

Annual bonus 10%

Job summary

Privia Health is seeking an AR Manager (Claims Billing Specialist) to ensure accurate and timely processing of claims, address denials, and coordinate with the Revenue Cycle Management team. The role involves working with physicians and practice consultants to optimize revenue cycle performance.

Qualifications include a high school diploma, 3+ years in medical billing, advanced Excel/Google Sheets skills, and HIPAA compliance. Remote work details and bonuses apply. Competitive benefits offered.

Qualifications

• High School Graduate.
• 3+ years experience in a medical billing office or equivalent claims experience.
• Advanced Excel/Google Sheets skills (pivot tables, VLOOKUP, sort/filtering, formulas).
• Experience with athenaHeath and/or athenaOne highly preferred.
• Experience working with New Jersey payers and providers preferred.
• Must comply with HIPAA rules and regulations.

Responsibilities

• Management of the accounts receivable (AR) including analysis of the aged AR, looking for root cause issues; suggesting billed rules/edits when appropriate to stop errors from occurring
• Denial management - investigate denial sources, resolve and appeal denials which may include contacting payer representatives via phone
• Make independent decisions regarding claim adjustments, resubmission, appeals, and other claim resolution techniques
• Collaborate with internal teams (Performance, Operations, Sales) as well as, care center staff when appropriate
• Support large care center go lives when applicable, which may include overnight travel
• Work closely with our Revenue Optimization team to support efforts to ensure reimbursement is in line with payer contract agreements. Perform denial analysis utilizing the Trizetto platform.
• Work directly with practice consultants or physicians to ensure optimal revenue cycle functionality
• Drive toward achievement of department’s daily and monthly Key Performance Indicators (KPIs)
• Other duties as assigned

Skills

Advanced Excel/Google Sheets

Medical billing experience

Independent decision making

HIPAA compliance

Denials analysis

Education

High School Graduate

Tools

athenaHeath

Job description

Privia Health is seeking an AR Manager (Claims Billing Specialist) to ensure accurate and timely processing of claims, address denials, and coordinate with the Revenue Cycle Management team. The role involves working with physicians and practice consultants to optimize revenue cycle performance.

Qualifications include a high school diploma, 3+ years in medical billing, advanced Excel/Google Sheets skills, and HIPAA compliance. Remote work details and bonuses apply. Competitive benefits offered.