AR Manager: Claims & Denials Expert

Priviahealth; United States; Presencial; USD 33.000 - 36.000; Tempo integral

Resumo da vaga

Privia Health is seeking an AR Manager to oversee the billing lifecycle, ensure timely processing of claims, and resolve denials in coordination with physician practices. You will manage aging AR, perform denial analysis, and collaborate with care teams to optimize reimbursement under payer contracts.

The role requires 3+ years in medical billing, strong Excel/Google Sheets skills, and experience with athenaHealth/athenaOne, plus HIPAA compliance.

Qualificações

• 3+ years experience in a medical billing office or equivalent claims experience.
• Must understand the drivers of revenue cycle performance and be able to investigate and resolve complex claims.
• Advanced Microsoft Excel/Google Sheets skills (pivot tables, VLOOKUP, sort/filtering, formulas) preferred.
• Experience with athenaHealth and/or athenaOne highly preferred.
• Experience working with New Jersey payers and providers preferred.
• Must comply with HIPAA rules and regulations.

Responsabilidades

• 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 KPIs
• Other duties as assigned

Conhecimentos

Excel/Sheets

HIPAA compliance

Denial management

Analytical skills

Formação

High School Diploma

Ferramentas

athenaHealth

athenaOne

Descrição da vaga

Privia Health is seeking an AR Manager to oversee the billing lifecycle, ensure timely processing of claims, and resolve denials in coordination with physician practices. You will manage aging AR, perform denial analysis, and collaborate with care teams to optimize reimbursement under payer contracts.

The role requires 3+ years in medical billing, strong Excel/Google Sheets skills, and experience with athenaHealth/athenaOne, plus HIPAA compliance.