Remote Claims Billing & Denial Specialist

Privia Health; United States; On-site; USD 33,000 - 36,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Vision insurance

Life insurance

Pet insurance

401K

Paid time off

Wellness programs

Job summary

Privia Health is seeking a Claims Billing Specialist (AR Manager) to ensure accurate and timely processing of assigned claims. The role includes addressing daily correspondence from physician practices, reviewing and appealing denials, and following up on aged claims.

Under the direction of the Revenue Cycle Management leadership, you will collaborate with performance, operations, sales, and care center staff, and may travel overnight for large go-lives.

Qualifications

• 3+ years experience in a medical billing office or equivalent claims experience.
• Must understand drivers of revenue cycle performance and resolve complex claims.
• Advanced Microsoft Excel/Google Sheets skills (pivot tables, VLOOKUP, sorting/filters, formulas) preferred.

Responsibilities

• Management of the accounts receivable (AR) including aged AR analysis and identifying root causes.
• Denial management: investigate, resolve and appeal denials; contact payer representatives as needed.
• Make independent decisions regarding claim adjustments, resubmission, appeals and other resolution techniques.
• Collaborate with internal teams and care center staff to support processes.
• Support large care center go-lives; may require overnight travel.
• Work with Revenue Optimization to ensure reimbursement aligns with contracts; perform denial analysis on Trizetto.

Skills

Medical billing experience

HIPAA compliance

Analytical skills

Independent decision making

Education

High School Diploma

Tools

athenaHealth / athenaOne

Trizetto platform

Pivot tables

VLOOKUP

Job description

Privia Health is seeking a Claims Billing Specialist (AR Manager) to ensure accurate and timely processing of assigned claims. The role includes addressing daily correspondence from physician practices, reviewing and appealing denials, and following up on aged claims.

Under the direction of the Revenue Cycle Management leadership, you will collaborate with performance, operations, sales, and care center staff, and may travel overnight for large go-lives.