Remote Claims & Denials RCM Specialist

Privia Health; United States; A distancia; USD 33.000 - 36.000; Jornada completa

Descripción de la vacante

Privia Health is seeking a Claims Billing Specialist (AR Manager) to ensure accurate and timely processing of claims. You will address daily correspondence from physician practices, review denials, and follow up on aged claims, including Salesforce case management where needed.

Your role will involve denial management, independent adjustments, and collaboration with Performance, Operations, Sales, and care center staff. Occasional overnight travel may be required as part of large go-live support.

Formación

• 3+ years experience in a medical billing office or equivalent claims experience.
• Must understand drivers of revenue cycle performance and resolve complex claims.
• Advanced Excel/Google Sheets skills (pivot tables, VLOOKUP, sort/filtering, formulas).
• Experience with athenaHealth and/or athenaOne preferred.
• HIPAA compliance required.

Responsabilidades

• Manage accounts receivable including aged AR analysis and root-cause issues.
• Investigate denial sources, resolve and appeal denials.
• Make independent decisions on claim adjustments, resubmission, appeals.
• Collaborate with internal teams and care centers as needed.
• Support large care center go-lives, may require overnight travel.
• Work with Revenue Optimization to ensure reimbursement aligns with contracts.
• Profile/drove KPIs for the department; engage with consultants and physicians.

Conocimientos

Denial management

Revenue cycle analysis

Excel/Google Sheets

Educación

High School Diploma

Herramientas

Excel/Google Sheets

athenaHealth/athenaOne

Salesforce

Descripción del empleo

Privia Health is seeking a Claims Billing Specialist (AR Manager) to ensure accurate and timely processing of claims. You will address daily correspondence from physician practices, review denials, and follow up on aged claims, including Salesforce case management where needed.

Your role will involve denial management, independent adjustments, and collaboration with Performance, Operations, Sales, and care center staff. Occasional overnight travel may be required as part of large go-live support.