Remote Claims Billing & AR Specialist

Privia Health; Oregon; Hybrid; USD 33,000 - 36,000; Full time

Job summary

Privia Health in Oregon is seeking a Claims Billing Specialist (AR Manager) to ensure accurate and timely processing of all assigned claims, address daily correspondence, review denials, and follow up on aged claims.

The role collaborates with Revenue Cycle, Performance, Operations, and Sales teams; involves denial analysis using Trizetto, and may require overnight travel to support large go-live events.

Qualifications

• High School Graduate
• 3+ years experience in a medical billing office or equivalent claims experience
• Must understand the drivers of revenue cycle optimal performance and be able to investigate and resolve complex claims
• Independent decision maker with strong research skills
• 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

Excel/Sheets

Education

High school diploma

Tools

AthenaHealth

AthenaOne

Job description

Privia Health in Oregon is seeking a Claims Billing Specialist (AR Manager) to ensure accurate and timely processing of all assigned claims, address daily correspondence, review denials, and follow up on aged claims.

The role collaborates with Revenue Cycle, Performance, Operations, and Sales teams; involves denial analysis using Trizetto, and may require overnight travel to support large go-live events.