Hybrid Insurance Refunds & Claims Specialist

Privia Health; Arlington (VA); Híbrido; USD 34.000 - 36.000; Jornada completa

Descripción de la vacante

Privia Health is seeking an Insurance Refunds & Claims Specialist for a hybrid role in our Arlington, VA office. This position handles insurance credits, refunds, and related inquiries, ensuring timely processing and regulatory compliance.

The role requires 3+ years in physician revenue cycle/claims management, experience with posting charges, and proficiency with Salesforce and AthenaOne EMR. HIPAA rules apply, and a productive, independent work style is essential.

Formación

• Education: High School Graduate and Medical Office training certificate or relevant experience.
• 3+ years experience in physician revenue cycle / claims management.
• Background with posting charges, claim follow up, collections, and payment posting.
• AthenaOne EMR experience preferred.
• Must comply with HIPAA rules and regulations.

Responsabilidades

• Identify and review patient accounts with insurance overpayments, ensuring accuracy and compliance with payer guidelines.
• Reconcile account balances by applying, transferring, or refunding credits where necessary.
• Analyze EOBs and insurance payments to verify credits and resolve discrepancies.
• Process refunds for insurance companies in a timely and accurate manner.
• Prepare and submit refund requests according to policies and payer workflows.
• Ensure proper documentation and communication regarding refund transactions with all relevant parties.
• Resolve outstanding credits or discrepancies by working with insurers, patients, and internal teams.

Conocimientos

Physician revenue cycle experience

Independent worker

Customer service

Educación

High School Graduate

Medical Office training or equivalent experience

Herramientas

Salesforce

AthenaOne EMR

Descripción del empleo

Privia Health is seeking an Insurance Refunds & Claims Specialist for a hybrid role in our Arlington, VA office. This position handles insurance credits, refunds, and related inquiries, ensuring timely processing and regulatory compliance.

The role requires 3+ years in physician revenue cycle/claims management, experience with posting charges, and proficiency with Salesforce and AthenaOne EMR. HIPAA rules apply, and a productive, independent work style is essential.