AR Manager (Medical Claims Billing Specialist)

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

Job summary

A leading healthcare technology company seeks an Accounts Receivable Manager to oversee medical claims billing operations. This full-time role involves managing AR processes, collaborating with various teams, and ensuring compliance with healthcare regulations. The ideal candidate will have strong interpersonal skills and a solid background in medical billing, particularly with major payers. The position offers a competitive salary and potential bonuses, along with a commitment to a diverse and inclusive work environment.

Benefits

Medical Insurance

Dental Insurance

Vision Insurance

401K

Paid Time Off

Wellness Programs

Qualifications

• At least 3 years of experience in a physician medical billing office.
• Experience with major payers such as Anthem, Medicare/Medicaid.

Responsibilities

• Manage accounts receivable (AR) and analyze aged AR.
• Handle denial management by investigating sources and resolving denials.
• Collaborate with internal teams and support large care center go-lives.

Skills

Advanced Microsoft Excel

Interpersonal Skills

Education

High School Diploma

Tools

Athena EHR

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 healthcare costs, achieves better outcomes, and improves the health of patients and providers.

Under the direction of the Director or Manager of Revenue Cycle Management, the Accounts Receivable (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 escalated to the RCM team. Resolving Salesforce cases and managing the team handling these cases is a key element of this role.

Primary Job Duties:

• Manage accounts receivable (AR), analyze aged AR, identify root causes of issues, and create rules to prevent errors.
• Handle denial management by investigating sources, resolving, and appealing denials, including contacting payer representatives.
• Make independent decisions regarding claim adjustments, resubmissions, appeals, and other 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 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 optimize revenue cycle functionality.
• Drive achievement of department KPIs through a team-focused approach.
• Perform other duties as assigned.

Minimum Qualifications:

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

Interpersonal Skills & Attributes:

• Comfortable speaking in front of groups
• Willing 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 (medical, dental, vision, life, pet insurance, 401K, paid time off, wellness programs). An annual bonus targeted at 10% may also be available. The offered salary will depend on experience, education, and location.

All information will be kept confidential according to EEO guidelines.

Technical Requirements (Remote Work):

Minimum internet speeds of 5 MBPS download and 3 MBPS upload are required, tested via https://www.speedtest.net/. Employees working remotely are eligible for expense reimbursement for internet costs.

Privia Health is committed to fostering a diverse and inclusive work environment, encouraging all individuals to bring their whole selves to work, regardless of age, race, gender, religion, disability, or other protected characteristics.