AR Manager (Medical Claims Billing Specialist)

Privia Medical Group; United States; Remote; USD 45,000 - 55,000; Full time

Job summary

An innovative healthcare firm is seeking an AR Manager to oversee medical claims billing and revenue cycle management. This role involves managing accounts receivable, resolving claim denials, and collaborating with various teams to optimize revenue processes. Ideal candidates will have experience in medical billing, particularly with major payers, and possess strong analytical skills. The position offers a competitive salary, potential bonuses, and opportunities for professional growth in a supportive environment. Join a forward-thinking company that values diversity and fosters an inclusive workplace.

Benefits

Medical Insurance

Dental Insurance

Vision Insurance

401K

Paid Time Off

Wellness Programs

Internet Cost Reimbursement

Qualifications

• 3+ years experience in a physician medical billing office.
• Experience with major payers such as Anthem and Medicare.

Responsibilities

• Manage accounts receivable and analyze aged AR.
• Handle denial management and resolve claim issues.

Skills

Medical Billing

Denial Management

Advanced Microsoft Excel

Revenue Cycle Performance

HIPAA Compliance

Education

High School Diploma

Tools

Athena EHR

Salesforce

Trizetto

Job description

AR Manager (Medical Claims Billing Specialist)

• Full-time
• Department: Revenue Cycle

Privia Health is a technology-driven, national physician enablement company that collaborates with medical groups, health plans, and health systems to optimize physician practices, improve patient experiences, and reward doctors for delivering high-value care in both in-person and virtual settings. The Privia Platform is led by top industry talent and exceptional physician leadership, and consists of scalable operations and end-to-end, cloud-based technology that reduces unnecessary healthcare costs, achieves better outcomes, and improves the health of patients and the well-being of providers.

Under the direction of the Director or Manager of Revenue Cycle Management, the AR Manager is responsible for the complete, accurate, and timely processing of all designated claims, reviewing and responding to daily correspondence from physician practices promptly, answering incoming Salesforce cases, and providing information as requested or properly authorized. The AR Manager will take necessary steps to resolve all claim issues or questions that escalate to the RCM team. Resolution of Salesforce cases and management of issues and the team resolving the cases are key elements of this role.

Primary Job Duties:

• Manage accounts receivable (AR), analyze aged AR, identify root cause issues, and write rules to prevent errors.
• Handle denial management by investigating denial sources, resolving, and appealing denials, which may include contacting payer representatives.
• Make independent decisions regarding claim adjustments, resubmissions, appeals, and other claim resolution techniques.
• Collaborate with internal teams (Performance, Operations, Sales) and care center staff as appropriate.
• Support large care center go-lives, which may include overnight travel.
• Work closely with the Revenue Optimization team to ensure reimbursement aligns with payer contract agreements. Perform denial analysis using the Trizetto platform.
• Work directly with practice consultants or physicians to ensure optimal revenue cycle functionality.
• Drive achievement of department’s daily and monthly KPIs through a team-focused approach.
• Perform other duties as assigned.

Minimum Qualifications:

• High School Graduate
• 3+ years experience in a physician medical billing office
• Experience with major payers such as Anthem, Medicare/Medicaid, United Healthcare
• Athena EHR experience required
• Behavioral Health physician billing experience preferred
• Experience supporting medical claims billing in DC/MD/VA preferred
• Understanding of drivers of revenue cycle performance and ability to investigate and resolve complex claims
• Advanced Microsoft Excel skills
• Compliance with HIPAA rules and regulations

Interpersonal Skills & Attributes:

• Comfortable speaking in front of groups
• Willingness to train and mentor team members
• Ability to work independently and multitask in a fast-paced environment

The salary range for this role is $45,000 to $55,000, excluding bonuses and benefits such as medical, dental, vision, life, pet insurance, 401K, paid time off, and wellness programs. The role is also eligible for an annual bonus targeted at 10%. The offered salary will depend on experience, education, and geographic location.

All information will be kept confidential according to EEO guidelines.

Technical Requirements (remote workers only):

Minimum internet speeds of 5 MBPS download and 3 MBPS upload are required, verified via online speed tests prior to employment. Employees working from home are eligible for expense reimbursement for internet costs.

Privia Health fosters an inclusive work environment encouraging employees to bring their whole selves to work, reflecting the communities served, regardless of age, race, gender, disability, religion, or other protected characteristics.