Remote Claims Billing Specialist: AR & Denials Expert

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

Benefits offered by this job

Annual bonus (10%)

Medical/dental/vision/Life insurance

401K and Paid time off

Wellness programs

Job summary

Privia Health is a technology-driven, national physician enablement company working with medical groups, health plans, and systems to optimize physician practices and patient experiences. The AR Manager role focuses on accurate, timely claims processing, denial resolution, and collaboration with care centers to meet KPIs in revenue cycle management.

The position offers an hourly base pay of $24–$26.45 with a potential annual bonus (approx. 10%) and standard benefits.

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.
• Advanced Microsoft Excel/Google Sheets skills (pivot tables, VLOOKUP, sort/filter, formulas) preferred.
• Experience with athenaHealth and/or athenaOne highly preferred.
• Experience working with New Jersey payers and providers preferred.
• Must comply with HIPAA rules and regulations.
• Independent decision maker with strong research skills.

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

HIPAA compliance

Independent decision making

Medical billing experience

A/R knowledge

NJ payer experience

Healthcare billing

Education

High School Graduate

Tools

Trizetto

athenaHealth/athenaOne

Job description

Privia Health is a technology-driven, national physician enablement company working with medical groups, health plans, and systems to optimize physician practices and patient experiences. The AR Manager role focuses on accurate, timely claims processing, denial resolution, and collaboration with care centers to meet KPIs in revenue cycle management.

The position offers an hourly base pay of $24–$26.45 with a potential annual bonus (approx. 10%) and standard benefits.