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AR Manager – Medical Claims Billing Specialist
| Company | Privia Health |
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| Location | DeSoto, TX, USA |
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| Salary | $45000 – $55000 |
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| Type | Full-Time |
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| Degrees | |
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| Experience Level | Mid Level |
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Requirements
- High School Graduate
- 3+ years experience in a physician medical billing office
- Experience with major payers such as Anthem, Medicare/Medicaid, United Healthcare
- Athena EHR experience required
- Must understand the drivers of revenue cycle optimal performance and be able to investigate and resolve complex claims
- Advanced Microsoft Excel 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; writing rules where appropriate to stop errors from occurring.
- Denial management – investigating denial sources, resolving and appealing denials which may include contacting payer representatives.
- Makes independent decisions regarding claim adjustments, resubmission, appeals, and other claim resolution techniques.
- Collaborate internal teams (Performance, Operations, Sales) as well as care center staff when appropriate.
- At times, support large care center go lives which may include overnight travel.
- Works closely with our Revenue Optimization team, to support efforts to ensure reimbursement is in line with payer contract agreements. Performs 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), requiring a team focused approach to attainment of these goals.
- Other duties as assigned.
Preferred Qualifications
- Behavioral Health physician billing experience preferred
- Experience supporting medical claims billing in DC/ MD/ VA preferred
